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TRICARE and Humana Military Healthcare Services are pleased to announce the new Behavioral Health Care Provider Locator and Appointment Assistance Line to help eligible active duty service members (ADSMs) and active duty family members (ADFMs) find behavioral health care providers and schedule outpatient appointments.
For eligible beneficiaries seeking assistance in the TRICARE South Region, Humana Military’s behavioral health partner, ValueOptions, Inc., manages the dedicated toll-free number at 1-877-298-3514, which is available from 8 a.m. to 7 p.m. Eastern Time, Monday through Friday. Note: This appointment assistance line is not a crisis intervention line. TRICARE beneficiaries seeking emergency behavioral health care assistance should call 911 or proceed to the nearest emergency room for treatment.
The primary goal of this new service is to assist beneficiaries in making timely appointments for routine and urgent behavioral health care. Keep in mind that TRICARE Prime primary care access standards concerning wait times also apply to behavioral health care appointments. Initial appointments for behavioral health care are not considered specialty care appointments.
The wait time for an initial urgent behavioral health care appointment with a behavioral health provider shall generally not exceed 24 hours. The wait time for an initial routine behavioral health care appointment shall not exceed one week. Following the initial appointment, the behavioral health care provider’s medical judgment will determine the wait time for the beneficiary’s follow-up appointments.
The appointment assistance service is available to all ADSMs and ADFMs enrolled in TRICARE Prime, TRICARE Prime Remote or TRICARE Prime Remote for Active Duty Family Members, as well as ADFMs enrolled in TRICARE Overseas Program Prime who have temporarily returned to the United States.
ADSMs do not need a referral if they seek care in the military treatment facility (MTF) and all ADSMs are encouraged to get care with military providers. However, if space is not available to meet the access standards, network referrals may be considered and a referral is required from the MTF to seek care from a civilian network provider. The referral may come from the primary care provider or from a behavioral health provider. ADSMs with a referral may contact the appointment assistance line to schedule an appointment with a network provider.
ADFMs do not need a referral for behavioral health care. They can self-refer for care. They may call the appointment line at any time to receive assistance in making an appointment. After the first eight outpatient visits in a fiscal year (Oct. 1–Sept. 30), TRICARE prior authorization is required to extend the care, but a referral is not necessary.
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