The CDC reports that about one-third of U.S. adults have utilized telemedicine services in the past year. In light of this, navigating the topic of insurance coverage for these online services can be challenging. Therefore, understanding the coverage options under TRICARE, especially for online therapy platforms like BetterHelp, is crucial.
While TRICARE does provide coverage for telehealth mental health services, BetterHelp is not a part of their in-network providers, and therefore their services are not directly covered by TRICARE. It’s advisable to review your TRICARE plan for specific details regarding telehealth coverage and out-of-network service reimbursement possibilities.
Let’s explore whether TRICARE takes and covers BetterHelp in more detail.
Does BetterHelp take TRICARE?
As of the latest information available, BetterHelp does not accept TRICARE. TRICARE, which provides healthcare services including mental health coverage to military personnel and their families, generally covers telehealth services. However, this coverage is restricted to in-network providers offering services through their own platforms or approved systems.
BetterHelp, known for providing online therapy with licensed therapists, isn’t currently considered an in-network provider under TRICARE. Consequently, services obtained through BetterHelp are not directly covered by TRICARE. This means that if you opt for therapy through BetterHelp, TRICARE won’t directly handle the payment for these services.
Nevertheless, if you’re covered by TRICARE and still wish to use BetterHelp, there are a couple of things you could consider:
- Out-of-Network Reimbursement: Depending on your specific TRICARE plan, there may be a possibility for out-of-network reimbursement. In this scenario, you would need to pay for BetterHelp services out of pocket initially and then submit a claim to TRICARE for reimbursement. The likelihood of reimbursement and the amount covered, if any, would depend on the terms of your particular plan.
- In-Network Telehealth Alternatives: If you prefer to use services covered by TRICARE without the additional steps of seeking reimbursement, you might want to explore other telehealth options that are within TRICARE’s network. This could involve consulting with your primary care provider or using TRICARE’s resources to find in-network therapists who offer online therapy sessions.
What is TRICARE?
TRICARE is a comprehensive health initiative designed for uniformed service members, their families, and retirees worldwide. It encompasses a wide range of health services including medical and dental plans, prescription coverage, and specialized programs.
The primary goal of this program is to support the military community by promoting, maintaining, and restoring both physical and mental health. It is inclusive of active-duty personnel, medically retired individuals, survivors, and retirees.
Participants may be required to contribute towards the cost of their health plan. This contribution, which could be in the form of coinsurance or copayments, varies based on the individual’s status and the specific health plan chosen. The table below compares the various plans:
BetterHelp’s Stance on TRICARE
BetterHelp has a unique approach regarding insurance plans, including TRICARE. While not explicitly rejecting these plans, BetterHelp suggests considering other options for several reasons:
Limited Coverage
Health plans like TRICARE often provide partial coverage, which might not be significantly beneficial. The administrative paperwork involved can be cumbersome, offering minimal financial relief compared to the effort required.
Cost Comparison
In some cases, the total cost of BetterHelp’s services may be lower than the co-pay required by insurance plans. Given BetterHelp’s affordability, primarily due to its online nature, using insurance could ironically lead to higher out-of-pocket expenses.
No Diagnosis or Prescription Services
Insurance companies usually require a formal diagnosis and treatment plan for coverage. BetterHelp’s model doesn’t include diagnosing patients or prescribing medication, which are typical prerequisites for insurance claims.
Direct Financial Aid
BetterHelp emphasizes its low-cost services and offers financial aid, potentially reducing session costs significantly. This direct assistance can be more efficient and economical compared to navigating through insurance coverage.
Global Accessibility vs. Specific Programs
BetterHelp caters to a global clientele, whereas TRICARE is specific to U.S. uniformed personnel. Integrating TRICARE into BetterHelp’s system could pose operational challenges, limiting the scope of those who could benefit from it.
Therefore, BetterHelp encourages clients to explore its services for affordability and customization, suggesting that relying on insurance might not be the most cost-effective or straightforward option.
Why Did TRICARE Decide to Expand Its Benefits
Increasing mental health issues in both military men and their families have resulted in TRICARE expanding its benefits, including coverage of online health platforms. Military families often face unique mental health challenges due to the nature of military life.
Service members may experience traumatic events during active duty, increasing the risk of mental health disorders such as post-traumatic stress disorder (PTSD), anxiety, and depression. These effects can extend to their families as well.
The demands of military life, including prolonged separation during deployments, also impact the mental health of service members’ spouses and children. A 2022 survey revealed that teenagers in military families often struggle with isolation, depression, and anxiety due to frequent relocations and the stress of having a parent in the military. Over 40% of these teens reported low mental well-being directly linked to their parents’ service.
Recognizing these challenges, the military has prioritized improving mental health support in recent years. This includes revising TRICARE health services and launching a committee to review the effectiveness of the military’s suicide prevention and mental health programs. The expansion of TRICARE benefits in 2022 is part of efforts to address the concerning mental health trends among service members, veterans, and their families.
Key Takeaways
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