Tricare Telehealth Copay

TRICARE Prime active duty family members and retirees do not need a referral or authorization.Only available in certain states at this time, but more are currently being added. Please contact Telemynd at (866) 991-2103 for more information about your state. Telemedicine services do not include texting. TRICARE will now waive cost-shares, copayments and deductible (if applicable) for covered telemedicine services from a military provider or TRICARE network provider. This waiver applies to all covered in-network telemedicine services, not just the services related to COVID-19. More providers able to offer covered telemedicine services.

Covered Services

Learn more about what we cover -
including health, dental, and pharmacy.
5/19/2020

To improve virtual access to health care during COVID-19, TRICARE recently revised its policy on telehealth services. This temporarily allows you access to care more easily during the national health emergency due to the pandemic. These changes will remain for the duration of the stateside public health emergency. They may be in place overseas beyond the U.S. national emergency end date, based on local conditions.

“Telemedicine has become an important tool in caring for patients while keeping providers and others safe during the COVID-19 pandemic,” said Christopher Priest, deputy assistant director, Health Care Operations, Defense Health Agency. “These changes will help TRICARE beneficiaries by making it easier for you to use telehealth services for your health care needs.”

Tricare

Here’s what you need to know about each of these temporary changes to telehealth visits:

1.Addition of audio-only health care visits

  • Covered telehealth visits required both live video and audio. TRICARE will now also cover audio-only telehealth services. This allows you to continue care with providers who may not usually use telemedicine. It allows those who don’t have in-home technology, such as smartphones or computers, to access care. This also makes it easier if you live in a rural area without broadband internet.

2. No out-of-pocket costs for covered telehealth services

  • You won’t have out-of-pocket costs for telehealth services that TRICARE covers. TRICARE will now waive your cost-shares and copaymentA fixed dollar amount you may pay for a covered health care service or drug., and deductible (if applicable) for covered telehealth services you get from a military provider or TRICARE network provider. This waiver applies to all covered in-network telehealth services, not just the services related to COVID-19.

  • What if you do have to pay? TRICARE can’t immediately waive all copayments and cost-shares. You may have to pay up front and file a claim with your TRICARE contractor for reimbursement. If you have questions, contact your TRICARE contractor.

3. More providers able to offer covered telehealth services

  • TRICARE policy requires providers to have a license in the state where they practice and where the patient lives. TRICARE will now reimburse providers for interstate care to patients. The care must be permitted by federal or state licensing laws.

  • This change will allow providers to respond to areas of high-need (physically and via telemedicine) during the national health emergency due to the pandemic without risking loss of reimbursement.

  • This change will also apply overseas. But, the provider must hold an equal license in the other country and the country where the provider practices must permit such practice.

Remember that not all providers offer telehealth services. You may need to ask your provider if they do. Depending on your TRICARE plan, you may also first need a referral or authorization. Your TRICARE contractor can assist you.

Tricare Telehealth Modifier 2020

Learn more about telemedicine and telemental services that TRICARE covers. Stay safe and take command of your health.

For more information about telehealth and the Defense Health Agency, visit health.mil

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At the time of posting, this information is current. Visit www.cdc.gov or TRICARE COVID Guidance for the most current COVID-19 information.

Costs

Find your TRICARE costs, including copayments,
enrollment fees, and payment options.
  • Most costs are for calendar year 2021 unless noted separately.
  • For US Family Health Plan and TRICARE Prime Remote costs, choose 'TRICARE Prime' from the pull-down menu
  • Visit the Cost Terms page for definitions to help you better understand TRICARE costs.
  • If you're an unremarried former spouse, for the Continued Health Care Benefit Program (CHCBP), chose 'Retired' regardless of your sponsor's status
  • Looking for dental costs? Visit the TRICARE Dental Costs section.

Tricare Telehealth Codes

When did the sponsor enlist in or was appointed to the uniformed services?

Tricare Telehealth Copay

Copayments will be waived retroactively to March 18 for certain testing and office visits related to the testing. The test must be one approved, cleared, or authorized by the Food and Drug Administration to detect SARS-CoV-2 or diagnose COVID-19. If you paid any copayments for testing related to COVID-19 and the resulting office visits with a network or non- network provider, you may file a claim for reimbursement. For more information related to the coronavirus, visit the FAQ page.