Using TRICARE for Therapy in New Bern, NC (and Online Across NC, SC, and VA)
If you have TRICARE, you’ve probably run into confusing terms like Prime, Select, in-network, and non-network.
As a result, it can be hard to know who you can see, whether you need a referral, and what’s actually covered. At Renewed Wellness Counseling, we believe understanding your benefits shouldn’t be the hardest part of getting care.
Below is a simple breakdown of how TRICARE works for therapy, and what it means when a practice like ours is a TRICARE Certified Non-Network Participating provider.
What Is TRICARE?
TRICARE is health insurance for active-duty service members, reservists, retirees, and their families. It covers medical and mental health care across several plan types, depending on your status and where you live.
The two main plans are TRICARE Prime and TRICARE Select.
The Difference Between TRICARE Prime and TRICARE Select
TRICARE Prime
TRICARE Prime is a more structured plan, with less choice around the providers you see.
In addition, you’re assigned a Primary Care Manager (PCM) who coordinates your care.
Learn more about this plan on the TRICARE Prime Overview.
Here’s how referrals work under TRICARE Prime:
- Active duty service members always need a referral from their PCM before seeing any mental health provider.
- Family members and retirees do not need a referral for in-network providers.
- A referral and authorization are required to see a
TRICARE Certified Non-Network Participating provider (like Renewed Wellness Counseling).
Quick heads up: PCMs often don’t approve referrals for Certified Non-Network Participating providers, especially if in-network
options exist, even if those options have long waitlists.
If your PCM or TRICARE doesn’t approve the referral, you can still see your preferred therapist using the Point of Service (POS) option.
That means you’ll pay more out of pocket but can still use your benefits. However, you’ll be able to see the provider of your choice.
Under POS, there’s a $300 deductible. After that, TRICARE covers 50% of the cost while you’re responsible for the rest.
Many members choose the POS option when they find a therapist who truly fits their needs.
Learn more about POS here: TRICARE Point of Service (POS).
TRICARE Select
TRICARE Select is the more flexible plan. For many members, it is also the simpler option for starting therapy.
You don’t need a PCM referral for therapy.
- You can see any TRICARE-approved provider, including Certified Non-Network Participating providers.
- You might pay a small copay or deductible, depending on your plan.
- Typically, TRICARE covers 80% of your session cost, and you cover the remaining 20%.
- Many families choose Select for its flexibility and fewer steps before starting therapy.
In-Network vs. Certified Non-Network Participating vs. Non-Participating Out-of-Network
In-Network Providers
- Fully contracted with TRICARE
- Lowest out-of-pocket cost
- No referral needed (except for active duty)
- Often fewer mental health providers available, which can mean longer wait times
Certified Non-Network Participating Providers
That’s where Renewed Wellness Counseling fits in. We’re approved by TRICARE but not under their in-network contract.
That means:
- We bill TRICARE directly for therapy sessions
- TRICARE Prime: Requires referral and authorization, or use of the POS option
- TRICARE Select: No referral needed. You can start right away.
This setup helps military families access care faster or find a provider who is a better fit.
This is especially true when local in-network options are limited or full in Eastern North Carolina, including New Bern.
Out-of-Network Providers
Not recognized by TRICARE. Clients pay fully out of pocket, and claims aren’t reimbursed.
What This Means for You at Renewed Wellness Counseling
Because we are TRICARE Certified Non-Network Participating provider, here’s what that means for you:
TRICARE Prime
If your PCM approves a referral, your therapy is covered like in-network care.
If not, you can still see us using the Point of Service option.
In other words, POS is a higher payment, but it gives you the freedom to choose your provider.
If you have questions about what to ask your PCM, how to start a referral, or how POS works, our team can guide you through the process.
TRICARE Select
No referral needed. You can schedule directly with us, and we’ll bill TRICARE for you.
Why Military Families Choose Certified Non-Network Participating Providers
Military families and reservists often face long waitlists for in-network therapy.
Because of that, working with a Certified Non-Network Participating provider can help you move forward sooner.
For example, it can offer:
- Access to care when in-network options are full
- Virtual therapy across North Carolina, South Carolina, and Virginia
- Therapists who understand military life, transitions, and trauma
Explore related support:
Our Deep Military Connection
Renewed Wellness Counseling is heavily military affiliated. Many of our clinicians are military spouses or have worked for years on military installations.
Because of that, we understand the culture, language, and lifestyle that come with military life. You don’t have to spend sessions explaining the basics.
Whether you’re navigating deployments, relationship or parenting challenges, reintegration, PCS transitions, or Reserve obligations, our team offers practical support that respects the realities of military family life.
You shouldn’t have to choose between quality care and convenience. Certified Non-Network care helps bridge that gap.
FAQs About TRICARE and Therapy
Do I need a referral for therapy?
It depends on your plan and status. Here’s the simple breakdown:
- Active duty: Always need a referral from your PCM.
- TRICARE Prime: No referral needed for in-network, but required for Certified Non-Network.
- TRICARE Select: No referral needed.
What’s the Point of Service (POS) option?
It’s when TRICARE Prime members see a provider without a referral. TRICARE still pays part of the cost, but your share is higher.
Learn more about it here: TRICARE POS Details.
Do I have to pay upfront?
Usually not. Once your referral (if needed) and authorization are approved, we bill TRICARE directly.
If you have a co-insurance, we’ll help you understand what to expect ahead of time.
Who can Renewed Wellness Counseling see with TRICARE?
We work with dependents, retirees, and reservists. Active-duty members must go through their PCM for mental health services.
Getting Started
Insurance details can be confusing, but you don’t have to figure them out alone.
Our team helps clients every day with referrals, authorizations, and TRICARE billing, including clients in New Bern, North Carolina and across NC, SC, and VA.
Whether you’re preparing for a PCS, balancing Reserve duties, or settling into civilian life, therapy can be a grounding place to reconnect and reset.
Get Matched with a Therapist or Contact Us to learn more about using TRICARE for therapy in NC, SC, and VA.
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