Triwest Mental Health Coverage
Mental health care is a core part of healthcare, particularly for military members, veterans, and their families, who may face unique challenges related to service, deployment, and transition. If you or your loved one is struggling with issues like depression, anxiety, PTSD, or other mental health challenges, work, school, relationships, and every other part of daily life can be affected.
For military members, veterans, and their families in the western United States, access to mental health services is often coordinated through TriWest Healthcare Alliance. TriWest does not act as an insurance provider. Instead, it administers care on behalf of TRICARE and, separately, the VA Community Care Network.
The people and families that serve our country often rely on these programs to access mental health care through approved provider networks. The services available, referral requirements, and costs depend on individual eligibility and coverage type.
This guide will explain:
- The difference between TriWest Insurance, TRICARE, and Community Care
- Information on TriWest’s beneficiaries
- TriWest therapy services and outpatient treatments
- Triwest inpatient mental health programs
- Other TriWest behavioral health coverage
- Frequently asked questions about TriWest Healthcare Alliance
What Is TriWest?
TriWest or TriWest Healthcare Alliance is a healthcare administrator that coordinates access to care for military families and Veterans in the western region of the United States. It was founded in 1996 and is based in Phoenix, Arizona. TriWest works together with the U.S. Department of Defense and the U.S. Department of Veterans Affairs (VA) to provide access to health care providers for military members and their dependents.
How TriWest Relates to TRICARE
TriWest administers access to care and provider networks for individuals covered by the TRICARE insurance plan. TRICARE is the healthcare program for U.S. Military active duty members, their families, and retirees. While TRICARE is the overall program, TriWest serves a 26-state group in the western region of the United States. TRICARE determines your benefits and eligibility, while TriWest helps coordinate access to covered services.
How TriWest Relates to VA Community Care
In addition to TRICARE, the VA Community Care Network (CCN) is a program that contracts with healthcare providers for veterans. TriWest manages CCN Regions 4 and 5, which cover most western states and Alaska, for the VA to help Veterans access care. TriWest develops and maintains the provider network, processes claims, and supports participating providers for VA-authorised care.1
Who Does TriWest Administer Care For?
TriWest administers access to care for military-connected individuals in the western United States. This includes TRICARE beneficiaries and, separately, eligible veterans receiving care through the VA Community Care Network. To access care through TriWest under TRICARE, you must be located in one of the western 26 states and be eligible for TRICARE. Veterans do not use TRICARE, and may access care through TriWest only when they are authorised for VA Community Care.1
Which Family Members Are Eligible Under TRICARE?
Under TRICARE, TriWest behavioral health coverage may include family members of active-duty service members, members of the National Guard and Reserve, retirees, retired reserve, Medal of Honor recipients, and Foreign Force members. Depending on eligibility and plan type, covered family members can include spouses, children, certain former spouses, parents and parents-in-law, and survivors.2 Coverage details, referral requirements, and costs vary by beneficiary category and TRICARE plan.
What Kind of Therapy Does TriWest Provide Access To?
TriWest behavioral health providers offer access to outpatient mental health services that are covered under TRICARE or VA Community Care. These services include outpatient psychotherapy, also known as “talk therapy”, and may be provided through individual, group, or family therapy. Coverage accessed through TriWest may also include telehealth services and medication management as part of the outpatient program.3
Through TriWest-administered programs, coverage may include forms of anxiety therapy, trauma counseling, and depression treatment. These services may be provided through outpatient programs or, when authorised and necessary, residential treatment settings within the network. Some of the therapy options covered include:
- Cognitive Behavioral Therapy (CBT)
- CBT is a form of psychological treatment that focuses on how we think and feel, and how to change behavioral patterns. It is used to help people manage and cope with anxiety, depression, and other mental health conditions.4
- Dialectical Behavioral Therapy (DBT)
- DBT is a type of CBT that focuses on individuals who experience overwhelmingly strong emotions. It is based around the idea that two things can be true: you can accept yourself for who you are and work to change any negative behaviors that no longer serve you.5
- Eye Movement Desensitization and Reprocessing (EMDR)
- EMDR is a form of treatment that involves moving your eyes in guided patterns while processing traumatic life events. It focuses on trauma and other upsetting memories to help you heal and move past the experience.6
- Acceptance and Commitment Therapy (ACT)
- This therapy is action-based and focuses on acknowledging painful experiences rather than avoiding them, and accepting your life for what it is. The idea of facing feelings of sadness, anger, or fear is intended to help change your attitude and emotional state.7
Which Therapies Are Not Typically Covered Through TriWest?
While individual, group, and family therapy may be covered when accessed through TriWest-administered programs, couples therapy or marriage counseling is generally not covered unless it is essential to the recovery from a mental health condition.
TriWest does not apply to alternative or non-clinical therapies, such as aromatherapy, life coaching, reiki healing, or acupuncture. In addition, the following services are generally accessible through TriWest behavioral health coverage:
- Sex therapy
- Psychedelic medications (including ketamine)
- Stellate Ganglion Blockade
- Transcranial Magnetic Stimulation (TMS) for anything other than treatment-resistant depression
- Electroconvulsive Therapy (ECT) or esketamine for non-FDA-approved uses
If there is a therapy that you would like to try, it is important to confirm coverage with both the treatment provider and TriWest before starting care to avoid unexpected costs.³
How Much is a Therapy Session with TriWest Healthcare Alliance?
Therapy sessions that involve evidence-based treatment like CBT, DBT, and EMDR are often covered when accessed under TRICARE or VA Community Care. Out-of-pocket costs depend on factors such as beneficiary status, plan type, referral requirements, and whether the provider is in-network.
Some families may have a copay or cost-share for outpatient therapy, while others may have no out-of-pocket cost at all. Costs can also differ between TRICARE and VA Community Care programs. Checking your specific benefits in advance is the most reliable way to understand what you may be responsible for paying.8
What Levels of Care Are Available Through TriWest?
TriWest insurance accepted therapy is available through the provider networks it administers, depending on eligibility and authorisation. Coverage accessed through TriWest may include both inpatient and outpatient mental health services under TRICARE or VA Community Care. These can range from higher levels of care, such as residential treatment and partial hospitalization, to structured outpatient treatment provided through approved providers. Below is a full list of the services that may be covered, based on individual circumstances:3
Inpatient services may include:
- Acute psychiatric hospitalization
- Residential treatment centers
- Substance use disorder rehabilitation facilities
Outpatient services may include:
- Outpatient treatment for mental health and substance use disorders
- Psychiatric partial hospitalization programs
- Intensive outpatient programs
- Medication assisted treatment
- Eating disorder treatment
- Psychological testing
- Opioid treatment programs
- TMS
- Electroconvulsive therapy
- Esketamine (Spravato) nasal sprays
- Telehealth services for mental health
Accessing Mission Prep Treatment Through TriWest
For quality, evidence-based mental healthcare for your teenager, reach out to Mission Prep today. We can discuss how your TriWest-administered coverage may help with treatment costs. We offer a range of supports to help your child overcome the mental health problems and challenges that come up in their daily lives.
Mission Prep has staff ready to answer your questions about our services, treatment plans, residential treatment, and more. Our locations are in California and Virginia; however, even if this is not where you live, many families find it beneficial to seek treatment in an environment away from home. This can allow your teenager to take space from their everyday life and focus on their recovery.
Contact Mission Prep to schedule an assessment or consultation today and help your teen begin the healing process.
Frequently Asked Questions:
Is TriWest a Medicare Plan?
No, TriWest is not Medicare, and it is not an insurance plan. Instead, TriWest administers care and may follow the billing deadlines, fee schedules, and payment methodology of Medicare. Medicare is a separate U.S. Government health insurance program that is focused on people 65 years or older. You may be eligible for both Medicare and care administered through TriWest, depending on your circumstances.9,10
Who Pays First, Medicare or TriWest?
Depending on whether you are on active duty and what services you are receiving, either Medicare or TriWest could pay first. For active duty members with Medicare, TriWest generally pays first, but for non-active duty members with Medicare, Medicare will pay first. Who pays first will also depend on who your primary insurance is and who is secondary. Your primary insurance always pays first, and the secondary may help if the primary does not cover the full service bill.11
Do I Need to See a Primary Care Doctor Before Starting Therapy?
Yes, you will usually need a referral from your primary care physician (PCP) to start therapy under TRICARE or VA Community Care programs administered through TriWest. Active duty members always need a referral for any care not rendered by their PCP. It’s also important to note that you can only get the care recommended in the referral by your PCP, so you should discuss your plan with them to ensure your treatment plan will be covered.12
References
- About TriWest. (n.d.). TriWest Healthcare Alliance. https://www.triwest.com/en/about/
- Intro to TRICARE. (n.d.). TRICARE. https://tricare.triwest.com/en/provider/intro-to-tricare/
- TriWest. (2025). Behavioral health coverage and requirements. TriWest Classification: Proprietary and Confidential (pp. 1–6) https://tricare.triwest.com/globalassets/tricare/provider/tricare-behavioral-health-coverage-and-requirements.pdf
- American Psychological Association. (2017). What is Cognitive Behavioral Therapy? https://www.apa.org. https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral
- Mind. (n.d.). What is dialectical behaviour therapy (DBT)? (n.d.). https://www.mind.org.uk/information-support/drugs-and-treatments/talking-therapy-and-counselling/dialectical-behaviour-therapy-dbt/
- Cleveland Clinic. (2025). EMDR Therapy. https://my.clevelandclinic.org/health/treatments/22641-emdr-therapy
- Psychology Today. (n.d.). Acceptance and commitment therapy. (n.d.). https://www.psychologytoday.com/us/therapy-types/acceptance-and-commitment-therapy
- TRICARE. (n.d.). Health plan costs. https://tricare.mil/Costs/Compare
- Centers for Medicare & Medicaid Services. (n.d.). CMS. https://www.cms.gov/
- Medicare. (n.d.). Who pays first? https://www.medicare.gov/health-drug-plans/coordination/who-pays-first
- VA Community Care Network. (n.d.). Billing & claims. https://vaccn.triwest.com/en/provider/provider-handbook/billing-and-claims/
- TRICARE. (n.d.). Do I need a referral for care? https://tricare.mil/FAQs/General/GEN_Referral
