Veterans and military families · Active duty and TRICARE
Active-Duty Military & TRICARE East Behavioral Health Care in Maryland
If you serve on active duty in Maryland, TRICARE East behavioral health care follows different rules than care for veterans or family members. This guide explains referrals, pre-authorization, the Brandon Act, costs and crisis care, based on what TRICARE and the Department of Defense publish.
Prefer to talk? Call (410) 231-0488

Key takeaways
-
Military clinics need no referral
TRICARE says active duty members do not need a referral or pre-authorization for outpatient mental health services at a military hospital or clinic.
-
Civilian care needs approval first
For care from a civilian provider in the TRICARE network, active duty members must get a referral and pre-authorization.
-
You can ask through your command
Under the Brandon Act, you can ask a commanding officer or supervisor for a referral for a mental health evaluation, for any reason.
-
Emergencies come first
No referral is needed in an emergency. If you are in crisis, call 911, go to the nearest ER, or call or text 988.
How TRICARE referrals work for active duty members
Where you get care decides which steps apply. According to TRICARE’s guide to getting mental health care, the rules for active duty service members are:
- At a military hospital or clinic: no referral or pre-authorization is needed for outpatient mental health services.
- With a civilian provider in the TRICARE network: you need a referral and pre-authorization before care starts.
- In an emergency: no referral or pre-authorization is needed.
Getting a referral for civilian care
Start with your primary care manager (PCM) or your military hospital or clinic. Tell them you are looking for behavioral health care, such as therapy or medication management, and ask whether they will refer you to a civilian provider. Once a referral is approved, ask what it covers, including the type of care, the provider and how long the approval lasts.
In Maryland, Humana Military is the TRICARE East Region contractor. You can call Humana Military at 800-444-5445 or visit Humana Military to check the status of a referral or find a network provider.
Family members follow different rules
Active duty family members are not held to the active duty rules. TRICARE says that, depending on your plan, you may need a referral or pre-authorization for outpatient mental health care, and seeing a non-network provider may cost more. Our couples and family counseling page explains how care for spouses and children works. If a child in your family has autism, see our guide to EFMP and TRICARE autism coverage for military spouses and families. Moving here on PCS orders with an autistic child? Our guide to PCSing to Maryland with an autistic child walks through the EFMP, ECHO and ACD handoffs. For Prime, Select and For Life rules in one place, see our TRICARE East behavioral health: direct access vs. referral rules guide.
Requesting a mental health evaluation under the Brandon Act

The Brandon Act created a way for service members to ask for help through their chain of command. According to the Department of Defense, you can request a referral for a mental health evaluation through a commanding officer or supervisor, for any reason, at any time and in any environment.
The Military Health System notes that service members can still contact a mental health provider directly. The Brandon Act is one path to care, not the only one.
Privacy and command notification
Many service members worry about what their command will learn. Department of Defense Instruction 6490.08 sets the rules for when military health care providers notify commanders about a service member’s mental health care. It was written to reduce stigma, and it limits notification to specific situations, such as safety concerns or duty-related risks.
Privacy rules can differ between military and civilian care, and between situations. Before you start, ask any provider how your records are handled and what may be shared with TRICARE or your command. If you hold a security clearance, our page on care for first responders and cleared professionals covers common questions.
What active duty members pay
According to TRICARE’s health plan costs, active duty service members do not have out-of-pocket costs for covered care. Following the referral and pre-authorization rules is part of keeping civilian care covered, so confirm your approval before your first visit.
Costs for family members depend on the plan, the beneficiary group and whether the provider is in the TRICARE network. Check TRICARE’s cost tables or ask your regional contractor what applies to you.
Virtual care and telehealth
TRICARE covers virtual mental health care. According to TRICARE’s virtual health page, referral requirements for virtual visits are the same as for in-person care, and active duty service members need a referral for all virtual health visits. Costs for virtual visits are the same as for in-person care.
Telehealth can make it easier to fit care around duty schedules, training and PCS moves. Our telehealth counseling page explains how video sessions work at Blue Sails.
Behavioral health care at Blue Sails
Blue Sails offers outpatient therapy for individuals, couples and families in Lusby, in Bethesda or by telehealth across Maryland, including trauma-focused care. Psychiatric medication management is also available.
Blue Sails accepts TRICARE. Military families comparing payer options can see TRICARE, commercial insurance and Maryland Medicaid side by side in our guide to autism testing and ABA funding in Maryland. If you are on active duty, have your referral and authorization details ready when you contact us, and our team can review next steps with you before you start. See insurance and billing, or call (410) 231-0488 with questions.
Our page on behavioral health care for Maryland veterans and military families and our veteran and military mental health guide cover more about how care works for military families.
In a crisis, you do not need a referral
If you are in crisis, call 911, go to the nearest ER, or call or text 988. Veterans, service members and their families can also press 1 after calling 988 to reach the Veterans Crisis Line.
TRICARE says no referral or pre-authorization is needed for emergency mental health care. If you are admitted to a hospital, TRICARE asks you to contact your PCM or regional contractor within 24 hours or by the next business day. The Veterans Crisis Line website also offers a confidential online chat.
Blue Sails is not an emergency service. Outpatient appointments are for scheduled care.
Frequently asked questions
Ask our team about therapy, psychiatry and your TRICARE coverage.
Do active duty members need a referral for civilian therapy?
Yes. TRICARE says active duty service members must get a referral and pre-authorization for mental health care from a civilian provider in the TRICARE network. No referral is needed for outpatient mental health services at a military hospital or clinic.
What do active duty service members pay for behavioral health care?
According to TRICARE, active duty service members do not have out-of-pocket costs for covered care. Following the referral and pre-authorization rules helps keep civilian care covered.
Do I have to go through my command to get care?
No. The Brandon Act lets you request a mental health evaluation referral through a commanding officer or supervisor, but the Military Health System notes you can still contact a mental health provider directly, including through your PCM or military clinic.
Does telehealth follow the same TRICARE rules?
Yes. TRICARE says referral requirements for virtual visits are the same as for in-person care, and active duty service members need a referral for all virtual health visits.
Do military family members need a referral too?
It depends on the plan. TRICARE says family members may need a referral or pre-authorization for outpatient mental health care based on their plan, and non-network providers may cost more. Ask Humana Military or our team what applies to you.
Talk with us about care while you serve
Tell our team what you are looking for and share your referral details if you have them. Therapy is available in Lusby, in Bethesda or by telehealth, and psychiatry is also available.
If you are in crisis, call 911, go to the nearest ER, or call or text 988.
