TRICARE Referrals: What to Know Before You Book

Why Referrals Matter

Referrals are not just administrative paperwork. In many systems, they are the mechanism that confirms medical necessity, routes specialty care, and aligns your visit with plan requirements. If a referral is needed and missing, coverage can be delayed or denied, even when the care itself is appropriate.

For online mental health care, referral workflows can affect both the first appointment and follow-up scheduling. Completing the required steps early helps avoid interruptions in treatment continuity.

Active Duty Service Members

Active duty pathways often involve more structured coordination than civilian pathways. Depending on current policy and local process, you may need referral approval through your PCM, military treatment facility, or command-directed workflow. In many cases, this step should be completed before a specialty behavioral health appointment is finalized.

Because active duty workflows can involve operational readiness and administrative requirements, timelines may differ from dependent pathways. Starting referral checks early is usually the safest approach.

Dependents and Family Members

Dependents may have more direct access in some plan scenarios, but referral requirements can still apply depending on plan type, network, and service category. For example, one dependent may be able to access covered telehealth therapy directly, while another may need a referral for the same service under a different plan setup.

The key is to avoid assuming that one family member's process applies to everyone in the household. Individual eligibility and referral pathways should be checked separately for each patient.

Therapy vs Psychiatry Referral Differences

Referral requirements can differ between therapy and psychiatry. Therapy may start with routine outpatient visits, while psychiatry can include additional layers such as medication planning and diagnosis-specific follow-up, which may trigger plan-specific authorization checks.

If you are unsure whether to begin with therapy or psychiatry, many care teams can guide triage during intake. In some cases, starting with therapy first creates a clearer path for deciding whether psychiatric consultation is needed.

How to Avoid Referral Delays

• Confirm your current plan and beneficiary status before scheduling.
• Ask directly whether referral or prior authorization is needed.
• Check whether your selected clinician is in-network for your plan.
• Keep referral numbers and documentation ready for intake.
• Re-verify if your plan recently changed due to relocation or status updates.

These steps can reduce avoidable back-and-forth and help your first visit happen on time.

Practical Next Step

If your goal is to start quickly, begin with a structured referral check, then choose the earliest appropriate appointment. The fastest path is usually not skipping referral verification; it is completing it early so booking and treatment can proceed without preventable friction.

This page is informational only and should not be treated as legal or coverage advice. Final referral and authorization rules depend on your specific plan and current policy guidance.