TRICARE is a health care program for members of the United States Armed Forces and their families. It’s a branch of the Department of Defense Military Health System and unites military health care resources with civilian health care providers. TRICARE West is the name of the TRICARE health care program in the Western part of the country. Earlier in September (2024) Kindbridge Behavioral Health announced that we would begin accepting TRICARE West coverage for all active and retired military personnel and their families. At press, this coverage includes military households of Arizona, California, Colorado, and Nevada and is expected to expand with the rising demand for our virtual therapy services.
As you may or may not know, Kindbridge has been in service to our nation’s servicepersons for quite some time. Our Colorado Military Veterans Project continues to be a model for how to treat a variety of mental and behavioral health issues that they struggle with. The addition of TRICARE West coverage represents another step toward our goal of providing first-rate counseling and therapy services to military households. It ensures easier access, reduces out-of-pocket costs, and provides another powerful layer of support for their well-being.
As a current or retired serviceperson you may be familiar with the mental health coverage provided by the TRICARE program. Common diagnoses detailed by the TRICARE website indicate coverage for the following:
- Post-Traumatic Stress Disorder (PTSD)
- Alcohol and drug abuse
- Anxiety
- Attention Deficit Hyperactivity Disorder (ADHAD)
- Depression
- Eating disorders
- Postpartum depression
TRICARE’s online resource also includes a list of exclusions. The program does not cover the following services (as they relate to today’s topic):
- Counseling services for stress management
- Counseling services for marital issues
- Sexual dysfunction therapy
You can reference the entire list of exclusions here.
While the program covers a great deal of mental health concerns, a number of active and retired servicepersons in the Western region have questions about TRICARE behavioral health coverage. It’s a logical concern given that behavioral health encompasses a broader spectrum of well-being. While direct answers to any question you have about TRICARE West coverage for your given behavioral health concern can be answered by speaking to a Kindbridge care coordinator (right here) we have provided valuable insight below.
What Active and Retired Military Servicepersons Need to Know About TRICARE West Coverage for Behavioral Health Concerns
Getting Help for Process Addictions When Not Directly Covered
As alluded to above, TRICARE West covers services that are medically necessary. They define medically necessary services as those that are “appropriate, reasonable, and adequate for your condition”. This condition must be considered proven and recognized by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Conditions that are not “diagnosable” are often categorized as behavioral addictions, also known as process addictions.
Process addictions are not like substance addictions. The desire to experience a “high” does not come from a substance (alcohol or drugs) but from the behavior itself. Compromised individuals often exhibit an inability to control thoughts, urges, and actions related to activities to the point that negative outcomes ensue. Process addictions include the likes of problem gambling, problem gaming, sex addiction and problematic use of pornography.
The problem with process addictions being excluded as being a proven condition in the eyes of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), is that it leaves many gaps in program coverage. Now here’s the real kicker – members of the military are more vulnerable than the general population to a number process/behavioral addictions. Below are links to resources discussing these vulnerabilities:
- Problematic sexual behavior in members of the military
- Link between military service and problem gambling
- Link between military service and problem gaming
Does the news regarding the gap in TRICARE behavioral health coverage leave you (or a loved one) in the lurch? Not at all. You see, while the program (and other insurance policies) may not stipulate coverage for issues such as problem gambling/gaming and hypersexuality, these issues generally cooccur with mental health concerns and disorders that are covered by TRICARE and TRICARE West (as per above). Kindbridge treatment strategies are holistic, treating not only the symptoms of process addictions but also underlying and comorbid conditions (those covered by TRICARE). Moreover, these holistic strategies are highly effective. Our most recent Gambling Disorder Treatment Outcomes Report indicated that in-treatment individuals exhibited the following notable improvements over a period of 12-sessions:
65.2% reduction in scores for Depression
*Standard industry benchmark is 50%
76.5% reduction in scores for Generalized Anxiety Disorder
*Standard industry benchmark is 50%
47.7% reduction in scores for Alcohol Use Disorder
In this example of Kindbridge successes, we show measurable progress for mental health concerns (depression, anxiety, and substance use disorder) that cooccur with a process addiction (problem gambling) that are typically covered by TRICARE. This is an example of how your overall treatment plan may be reimbursable at a rate in the 60% to 80% range.
Other Options to Supplement Coverage
It’s good to know that you may be covered for mental health conditions that often cooccur with behavioral health issues and that this can significantly reduce the cost of a customized treatment strategy. However, there are other ways to supplement coverage.
For instance, coverage for problem gambling treatment for active and inactive veterans may be available via compensation through a VA Disability Rating. View more on how to increase your VA disability rating to cover problem gambling which may potentially be applied to the treatment of other behavioral addictions.
Further, your household might enjoy added coverage through employer (non-military) and private insurance policies, many of which allow behavioral addiction counseling and therapy through standard mental health treatment inclusions. When everything is taken together, active and retired members of the military have even more affordable access to behavioral health services through Kindbridge.
Again, the best way to find direct answers to any question you have about TRICARE West coverage for a given behavioral health concern can be answered by speaking to a Kindbridge care coordinator. All that you need to do is reach out via your preferred contact below and we’ll take care of the rest.
Ask About TRICARE Behavioral Health Coverage Through Kindbridge
CALL +1 (877) 426-4258
OR
Email [email protected]
