Mental Health Office Visits
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Plan
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Benefit Year 2026
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Active-Duty Family Members or Retirees and Family Members Who Also Carry Medicare Part B (including Medicare Advantage)
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In-Network: $0 copay
Out-of-Network: 50% coinsurance
Deductible (Out-of-Network Only): $300 (Individual) / $600 (Family)
Authorization: No
Referral: No
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Retirees and Family Members Who Do Not Carry Medicare Part B
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In-Network: $39 copay
Out-of-Network: 50% coinsurance
Deductible (Out-of-Network Only): $300 (Individual) / $600 (Family)
Authorization: No
Referral: No
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Important Note: Please be aware that if the provider is out-of-network, the Point of Service (POS) cost share will apply unless it is medically necessary to seek services out-of-network. To request a review for in-network benefit cost share, call the Behavioral Health Care Program (BHCP) at 1-800-708-4532 prior to rendering services. If approved for in-network, the standard network benefit applies. If approved for out-of-network, the POS benefit applies. Additional services not listed in this benefit may require a referral or authorization.
Mental Health Crisis Visit
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Plan
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Benefit Year 2026
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Active-Duty Family Members or Retirees and Family Members Who Also Carry Medicare Part B (including Medicare Advantage)
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In-Network: $0 copay
Inpatient Setting: Appropriate inpatient cost share applies
Out-of-Network: Exempt, applies in-network rates
Authorization: No
Referral: No
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Retirees and Family Members Who Do Not Carry Medicare Part B
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In-Network: $39 copay
Inpatient Setting: Appropriate inpatient cost share applies
Out-of-Network: Exempt, applies in-network rates
Authorization: No
Referral: No
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Important Note: Mental health services do not require a referral. For any authorization needs or out-of-network reviews, please contact the Behavioral Health Care Program (BHCP) at 1-800-708-4532.
Mental Health Inpatient Admission (0–18 Years)
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Plan
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Costs
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Active-Duty Family Members
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Authorization: Yes, BHCP authorization required
Referral: No
In-Network Copay: $0
Out-of-Network: POS exempt, in-network cost share applies
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Eligible Dependents (Non-Medicare)
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Authorization: Yes, BHCP authorization required
Referral: No
In-Network Copay: $0
Out-of-Network: POS exempt, in-network cost share applies
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Important Note: Mental health inpatient admissions for patients aged 0-18 years require prior authorization from the Behavioral Health Care Program (BHCP). Please call 1-800-708-4532 prior to rendering services to confirm authorization. Additional services not listed may require a referral or further authorization.
Mental Health Inpatient Admission (19+ Years)
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Plan
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Benefit Year 2026
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Active-Duty Family Members or Retirees and Family Members Who Also Carry Medicare Part B (including Medicare Advantage)
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Authorization: Yes, BHCP authorization required
Referral: No
In-Network Copay: $0
Out-of-Network: POS exempt, in-network cost share applies
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Retirees and Family Members Who Do Not Carry Medicare Part B
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Authorization: Yes, BHCP authorization required
Referral: No
In-Network Copay: $198 per admission
Out-of-Network: POS exempt, in-network cost share applies
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Important Note: Inpatient admissions for ages 19+ require prior authorization from the Behavioral Health Care Program (BHCP). Please call 1-800-708-4532 prior to rendering services to confirm authorization. Additional services not listed may require a referral or further authorization.
Psychotherapy Individual Benefit
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Plan
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Benefit Year 2026
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Active-Duty Family Members or Retirees and Family Members Who Also Carry Medicare Part B (including Medicare Advantage)
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In-Network Specialist Copay: $0
Outpatient Setting: $0
Inpatient Setting: Mental health inpatient cost share applies
Authorization: Check if required
Referral: No
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Retirees and Family Members Who Do Not Carry Medicare Part B
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In-Network Specialist Copay: $39
Outpatient Setting: $39
Inpatient Setting: Mental health inpatient cost share applies
Authorization: Check if required
Referral: No
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Important Note: Some services may require prior authorization. To request a review for the in-network benefit cost share, please call the
Behavioral Health Care Program (BHCP) at 1-800-708-4532 prior to rendering services. If approved, the standard network benefit applies. Additional services not listed may require a referral or authorization.
