All TRICARE Prime beneficiaries except active duty service members (ADSMs)* may self-refer to most
providers for the first eight outpatient behavioral health care visits per fiscal year (Oct. 1–Sept. 30). To avoid point of service (POS) charges, beneficiaries must seek services from a TRICARE network provider. However, if a TRICARE Prime active duty family member calls the Behavioral Health Care
Provider Locator and Appointment Assistance Line at 1-877-298-3514, he or she may be given the name of a non-network provider if a network provider is not available in his or her area. This constitutes prior authorization to seek care from that non-network provider, and POS charges are waived.
 
The non-network provider must obtain the prior authorization from Humana Military Healthcare Services,
Inc. (Humana Military).
 
It is important to keep in mind that there are certain behavioral health care providers for which a physician referral and continuing oversight and supervision are always required, even for the first eight outpatient visits. These providers include licensed professional counselors, licensed mental health counselors and pastoral counselors.
 
If you have questions about behavioral health care referral requirements, call Humana Military’s behavioral health unit at 1-800-700-8646.
 
 *ADSMs must always obtain a referral for behavioral health care.