Is Marriage Therapy Covered Under Tricare Reserve Select?

TRICARE, the healthcare program for military and military family members, covers marriage counseling under certain circumstances to treat a diagnosed mental health illness. However, it only covers marriage counseling when it is necessary for the treatment of a mental disorder. Tricare Reserve Select does not cover individual or marriage counseling unless necessary for a “diagnosed mental health condition”.

Tricare provides coverage for counseling services that are medically necessary and appropriately authorized. Spouses of active duty, reserve, and retired members are eligible for TRICARE coverage, and dependents of active and retired members are automatically covered as soon as they are enrolled. To receive medical counseling, service members and spouses from each branch of the military, including National Guard members, reservists, and DoD civilian employees who have deployed overseas, are automatically covered.

TRICARE Prime beneficiaries must have an approval from HNFS to see a non-network provider unless they choose to use their Point of Service option. TRICARE Select beneficiaries do not. These rules apply to TRICARE Prime and TRICARE Select. If you use TRICARE For Life, marriage is a QLE for your spouse if they’re under age 65.

TRICARE only covers marriage counseling when it is necessary for treating a diagnosed mental health disorder. Family counseling is considered outpatient psychotherapy and is a covered benefit when determined to be medically or psychologically necessary for treatment of a mental health condition.

Getting married is a TRICARE Qualifying Life Event, meaning newlyweds have 90 days to make eligible changes to their TRICARE plan, including outpatient counseling and therapy, inpatient mental health care, and prescriptions.

What Services Does Tricare Cover?

TRICARE provides extensive coverage for mental health services and substance use disorders, often referred to as therapy or counseling. It includes psychological testing and assessments for diagnosing conditions and creating treatment plans, but does not cover such testing for academic purposes. TRICARE aims to support the health of its beneficiaries, which includes nearly 9. 5 million service members, retirees, and their families worldwide. Coverage encompasses a range of services, such as health care, dental, and pharmacy, allowing users to maximize their benefits and minimize unexpected expenses.

Active-duty members, retirees, and their families typically use TRICARE Prime, TRICARE Select, or other TRICARE plans. While TRICARE generally covers medically necessary and proven services, it excludes coverage for certain services related to research studies. Beneficiaries can check what is covered by visiting the "Is It Covered" page, where they can search by keyword or browse categories for specific health services and supplies.

What Is TRICARE Reserve Select Coverage?

TRICARE Reserve Select (TRS) is a premium-based PPO-style health plan designed for Selected Reserve members and their families, offering worldwide coverage for doctor visits, hospitalizations, tests, and prescriptions. Unlike active-duty plans, beneficiaries must pay monthly premiums along with potential out-of-pocket costs such as copayments and deductibles. Eligibility for TRS excludes members on active duty orders exceeding 30 days or those covered under the Transitional Assistance Management Program.

The plan is a self-managed option, enabling beneficiaries to select authorized providers without needing prior approval from a primary care manager. TRS is considered minimum essential coverage and allows continuity of care for existing providers. Enrollment is available year-round, and the plan offers comprehensive healthcare benefits, including prescription drug coverage. Other TRICARE plans include TRICARE Prime, TRICARE Select, TRICARE For Life, and TRICARE Plus, with TRS functioning as a preferred-provider option for those not activated.

What Is Not Covered By TRICARE Reserve Select?

TRICARE Reserve Select (TRS) is a healthcare plan offering health and vision benefits to members of the Selected Reserve and their families, but excludes dental and pharmacy coverage. TRS coverage is not available to reservists on active duty for more than 30 days, retirees, or families of reservists under active-duty orders. Members covered by the Transitional Assistance Management Program also do not qualify for TRS. For those seeking TRICARE Reserve Select, it is essential not to select Federal Employees Health Benefits (FEHB) if not a federal employee, as this will disqualify them for TRICARE Reserve Select.

TRICARE Reserve Select aligns with benefits similar to TRICARE Select, including the same cost-shares and deductibles as Group B active duty family members. Additionally, TRICARE Select operates as a fee-for-service insurance plan allowing various doctor visits at minimal copays. However, certain services and items—including non-prescription medications for fertility or cosmetic purposes—are typically not covered by TRICARE.

Importantly, individuals in the Individual Ready Reserve and certain training units do not qualify for TRICARE coverage. Members must understand eligibility criteria and plan limitations before enrollment.

Does TRICARE Require A Referral For Counseling?

You can access care from a supervised mental health counselor or pastoral counselor, although a doctor must supervise the treatment within the TRICARE network. Certified mental health counselors (CMHCs) do not require a doctor’s referral or supervision. Preventive services and outpatient mental health visits do not need referrals if obtained from a TRICARE network provider. Hospital stays require a referral and pre-authorization. Outpatient mental health care, except psychoanalysis, and substance use disorder services do not need referrals or pre-authorization.

For TRICARE For Life, referrals are generally unnecessary since Medicare is the primary payer for mental health care. Dependents can see a local mental health provider in the TRICARE network without an initial referral until follow-up referrals become necessary. Active duty service members need a referral from their primary care manager (PCM) for counseling. Under TRICARE Prime, referrals for specialist visits are required; however, network providers for outpatient mental health services do not require a referral.

TRICARE Select allows visits to any TRICARE-authorized provider without referrals. Overall, while most beneficiaries do not need referrals, Active Duty members must adhere to referral requirements, ensuring access to necessary mental health care. Emergency services, however, bypass these referral protocols.

Does The Military Offer Couples Counseling?

The Military and Family Life Counseling Program provides free, confidential non-medical counseling services for military couples, both face-to-face and via telehealth, addressing relationship concerns. Support is readily available through your installation's Military and Family Support Center, offering individual, couples, or family counseling, as well as support groups. The program understands the unique challenges faced by military families, including deployment stress and reintegration.

While TRICARE covers marriage counseling only for diagnosed mental disorders, various resources exist to assist couples in managing relationship issues. Military OneSource and the Family Advocacy Program extend additional support, connecting couples with peer coaches who are Veterans or military spouses. The Defense Department acknowledges the support gap and thus provides extensive free resources to aid service members and their families. This program aims to help military couples navigate difficulties related to communication, parenting, and assimilation after service.

Some VA hospitals also offer marriage and family counseling. Overall, counseling services help strengthen military relationships through confidential support and valuable resources, emphasizing that seeking help signifies strength.

Does TRICARE Reserve Select Pay For Counseling?

TRICARE provides a range of nonemergency mental health services including therapy and counseling. Beneficiaries with TRICARE Prime do not require a referral for outpatient mental health services within the network, while TRICARE Select members can access any TRICARE-authorized provider, although costs may be lower for network providers. TRICARE Reserve Select offers diverse mental health services, including individual and group therapy as well as specialized treatments for conditions like PTSD.

Coverage includes psychological testing and assessments essential for diagnosis and treatment planning, but screening for academic placement is excluded. For non-network provider visits or referrals from a network provider in another region, point-of-service fees apply. Marriage counseling is covered only when necessary for treating a diagnosed mental disorder.

TRICARE Select, TRICARE Young Adult Select, and TRICARE Reserve Select have annual deductibles, and costs vary depending on provider choice. TRICARE For Life operates with Medicare as the primary payer. Supervised care from mental health or pastoral counselors is also covered under guidelines. Access to a variety of mental health services is crucial for maintaining mental and physical well-being, with costs for services like administrative forms required for reimbursement in out-of-network scenarios. For immediate help, the Veterans Crisis Line is available 24/7 at 988, then press 1.

Does TRICARE Provide Marriage Counseling?

TRICARE covers marriage counseling only when it's necessary for treating a diagnosed mental disorder. While TRICARE does provide access to services that are medically necessary, any covered counseling must be authorized appropriately. Specifically, marriage counseling is available as part of mental health services, including support for relationship issues, when one partner demonstrates symptoms meeting DSM criteria. Couples can receive up to eight mental health visits through TRICARE without needing a referral, especially if enrolled in TRICARE Select.

For those with TRICARE For Life, marriage is considered a qualifying life event for spouses under 65. Military couples facing challenges can utilize confidential counseling and various online tools for support. However, it is essential to note that TRICARE's coverage for marriage counseling is limited strictly to instances where mental health treatment is required. Those seeking counseling for general relationship concerns may need to explore other options, as TRICARE's focus is on mental health-related needs. For more detailed information about eligibility and services, it is advisable to consult TRICARE directly.

Does TRICARE Cover Divorced Spouses?

Former spouses of military members can retain eligibility for TRICARE under specific conditions, and non-adopted stepchildren lose their eligibility post-divorce. The Continued Health Care Benefit Program (CHCBP) offers up to 36 months of coverage after divorce, provided applications are made within 60 days. If a former spouse remarries, they typically forfeit TRICARE benefits, unless marrying another active duty or retired service member. Eligibility for TRICARE ceases at the time of divorce unless certain criteria are met, including the service member's 20 years of creditable service.

Under the conditions that maintain eligibility, former spouses can utilize their own names and health benefit numbers for care and claims. Failure to report changes in coverage could lead to recoupment of claims paid during ineligibility periods. If divorce occurs, the eligibility timeline for care applies based on several stipulations, including the date of the divorce or previous eligibility under certain historical parameters. Notably, separated spouses retain TRICARE coverage until legal divorce finalization.

After meeting the stipulations, former spouses share equivalent benefits to retired family members, which vary depending on their geographic location. Documentation, such as marriage and divorce certificates alongside military service forms, proves necessary for accessing TRICARE as a former spouse. Overall, understanding TRICARE coverage changes is vital for former military spouses and their dependents.

Who Is Eligible For Tricare If I Marry A New Spouse?

When you marry a service member, you and potentially your new spouse's children, including biological, adopted, and stepchildren, may become TRICARE-eligible. Children are covered until age 21, or up to 23 if they are full-time students. Within 90 days of marriage, you need to register your spouse and stepchildren in the Defense Enrollment Eligibility Reporting System (DEERS) to access TRICARE benefits. First, ensure your spouse is registered in DEERS, as this is essential for obtaining TRICARE coverage.

It's important to update DEERS before making changes to your health care plan. If your spouse is active duty, retired, or a Guard-Reserve member, stepchildren can be covered as long as the natural parent and the service member are married. Spouses of retirees maintain the same benefits as the retiree, including health coverage. Once registered in DEERS, they can enroll in TRICARE Prime or TRICARE Select, depending on their location. You’ll need to present documentation like your marriage certificate and IDs.

Getting married qualifies as a TRICARE Qualifying Life Event (QLE), enabling you 90 days post-marriage to adjust your coverage. Generally, only spouses and children qualify for TRICARE, but in certain cases, dependent parents may also be eligible.

What TRICARE Plan Do Military Spouses Have?

You may qualify for several TRICARE health plans based on your military affiliation, including TRICARE Prime, TRICARE Select, US Family Health Plan, TRICARE Select Overseas, and TRICARE For Life. TRICARE Select covers the immediate families of active duty members, military retirees, and certain Guard/Reserve members, along with their survivors. Spouses of active duty personnel can enroll in TRICARE Prime or TRICARE Prime Remote with their sponsors.

Active duty family members also have access to TRICARE Select Overseas, which is tailored for families living abroad. Additionally, TRICARE For Life (TFL) is available for military retirees and their families qualified for both TRICARE and Medicare. Once registered in DEERS, new spouses and stepchildren can enroll in a TRICARE plan. Active duty families typically experience low out-of-pocket costs, although the specifics can vary. Navigating TRICARE can become complex after age 65, especially when considering other health insurance (OHI) options.

Marriage triggers a TRICARE Qualifying Life Event (QLE), allowing family members to adjust their healthcare enrollment. Overall, TRICARE provides important healthcare access for military families, but options differ based on military status and location.

Does TRICARE Reserve Cover Vasectomy?

TRICARE provides coverage for vasectomies and tubal ligations, while surgical sterilization reversal may be covered if deemed medically necessary due to a disease or injury. However, hysterectomies for sterilization purposes are not covered by TRICARE. It is essential for beneficiaries with TRICARE For Life who reside in the U. S. or U. S. Territories to adhere to Medicare's regulations. There are distinct coverage types for military dependents and service members.

Military dependents can access TRICARE's health coverage, which includes vasectomies, but reversals are only covered if medically necessary. Note that vasectomies can be performed bilaterally or unilaterally as covered procedures. While TRICARE covers various contraceptive methods, including assisted reproductive services, it doesn’t extend to procedures not medically necessary. Additionally, military family members, reservists, and some retirees are eligible for tubal ligation surgeries from civilian doctors without out-of-pocket expenses. For further information, refer to the Surgical Sterilization page on the TRICARE website.

Are Same Sex Spouses Covered By Tricare?

Same-sex spouses are eligible for TRICARE coverage upon enrollment in DEERS. Coverage ceases if a spouse divorces their eligible sponsor or remarries after the sponsor's death. Common law couples and cohabitating partners do not qualify. Married couples, including same-sex spouses, have a 90-day window from the date of marriage, a Qualifying Life Event, to enroll their spouse in TRICARE and modify health plans. Required documentation includes a marriage certificate, birth certificate, Social Security card, and a photo ID.

Entitlements extend to all married service members, including those in same-sex marriages, covering health care, Basic Allowance for Housing, and survivor benefits. Active duty, retired, and Guard/Reserve spouses are also included in these benefits. The Department of Defense (DoD) plans to update policies regarding infertility treatments to offer coverage to unmarried and same-sex married active-duty members as well.

Additionally, same-sex military couples will have access to veterans' pensions, VA home loans, medical coverage, and burial benefits. For claims regarding care received before or after June 26, 2013, same-sex couples married prior to that date can file claims. TRICARE also provides some coverage for assisted reproductive procedures, although both parents’ rights may not be automatic in same-sex couples.