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1.  Entitled to Access Standards
2.  You Don't Have to Live with Depression
3.  Frequently Asked Questions about Behavioral Health Care
4.  TRICARE and VA Work Together for Your Benefit
5.  The Importance of Being Current
6.  Contacts
Entitled to Access Standards (Article 1)
The Care You Need, When and Where You Need It

You don’t need “abracadabra” or “open sesame” to unlock the doors to prompt, quality health care. No need for magic carpets either. When you’re a TRICARE Prime member, access to care in a timely manner and within a reasonable distance from home is guaranteed.

Access Standards
As a TRICARE Prime member, you are guaranteed an appointment within the following access standards:

  • For urgent care, you should have an appointment within 24 hours.
  • For routine care, you should have an appointment within one week.
  • For specialty care or a wellness visit, you should have an appointment within four weeks (28 days).

Once at the appointment, you should be seen within 30 minutes for nonemergency care.

At times, however, you may experience high-demand specialty services where appointments may not be readily available within the TRICARE standards. It is important to contact your provider directly and make your appointment based on your schedule and the provider’s availability.

Drive Time
Additionally, you should have a primary care manager whose office is within 30 minutes of your home under normal circumstances, and specialty care should be available within one hour of your home.

Call if There's a Problem
If you experience situations where a provider cannot adhere to these standards, contact Humana Military Healthcare Services at 1-800-444-5445.

You can also speak to a Beneficiary Counseling and Assistance Coordinator (BCAC) about customer service issues. To find the nearest BCAC, call your local military treatment facility (MTF) or visit www.tricare.osd.mil/bcac and search the BCAC directory.
 You Don't Have to Live with Depression (Article 2)
Help Is a Phone Call Away
Everyone gets the blues now and then. But how can you tell the difference between a temporary reaction and chronic, treatable depression?

Depression is a mood disorder that causes symptoms, such as low energy, prolonged sadness or irritability, and lack of interest in daily activities. Other symptoms may include changes in appetite or sleep, problems with concentrating, decreased sexual drive and thinking about death.

Causes of depression include chemical imbalances, stressful situations, genetic history or a combination of all three. Environmental factors, such as blood pressure medications, also can trigger depressive episodes. Some new mothers experience postpartum depression.

It is important to note that depression is a medical condition, not a character flaw. Many people with depression do not seek treatment because they are embarrassed or think they should “get over it” on their own.

Left untreated, however, depression can change your behavior, physical health and appearance, work performance and your ability to handle everyday decisions and pressures. Fortunately, TRICARE beneficiaries are entitled to comprehensive and confidential behavioral health care benefits.

Start by Calling a ValueOptions Agent
“There is no reason to live with depression,” says Roxane Kissinger, director of customer service at ValueOptions.

If you suspect or know that you are depressed, you have resources available to help you get assistance. Your primary care manager (PCM) can refer you for treatment, or you can self-refer with one phone call to ValueOptions, Humana Military’s behavioral health care subcontractor, at 1-800-700-8646.

“Our automated menu is small and easy to navigate, with very short holding times,” Kissinger explains. “You will quickly be put through to a live person who can recommend a behavioral health care provider in your area, help you with authorizations, explain any copayments you may have, answer questions about inpatient treatment and much more.”

Treatment typically includes a series of psychotherapy visits and, in some cases, medication. (Many do well with combined treatment—medication to gain symptom relief and psychotherapy to learn effective ways to deal with life problems.)

TRICARE Prime coverage permits up to eight unmanaged outpatient visits per beneficiary per fiscal year (see “FAQs about Behavioral Health Care” on page 2 for more information). If your behavioral health care provider deems it medically necessary, he or she will request additional visits on your behalf.

So, don’t ignore symptoms of depression. Call ValueOptions today at 1-800-700-8646.

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Last Reviewed:  December 4, 2007