TRICARE Coverage for ADHD (Attention-Deficit/Hyperactivity Disorder)
Overview
TRICARE covers ADHD diagnosis and treatment for both children and adults. Coverage includes comprehensive evaluations, behavioral therapy, medication management, and school/workplace accommodations support. ADHD is one of the most common behavioral health conditions among military dependents.
Treatment Options Covered by TRICARE
- Comprehensive neuropsychological evaluation
- Behavioral therapy and counseling
- Medication management (stimulants and non-stimulants)
- Parent training and behavior management
- Social skills training
- Academic/occupational coaching support
- Cognitive behavioral therapy (CBT)
- Follow-up medication monitoring
How TRICARE Covers ADHD (Attention-Deficit/Hyperactivity Disorder)
TRICARE covers all medically necessary ADHD services including evaluation, therapy, and medication. Common ADHD medications (Adderall, Ritalin, Concerta, Strattera, Vyvanse) are on the TRICARE formulary. There are no annual visit limits for outpatient behavioral health.
Coverage by Plan
TRICARE Prime
Diagnostic evaluation and therapy at $0 with PCM referral. Medications at $0 from military pharmacy. No visit limits for behavioral health.
TRICARE Select
Standard outpatient cost shares apply. $28 network copay for therapy sessions. Can self-refer to behavioral health providers.
TRICARE For Life
Medicare + TFL covers behavioral health services. Standard cost shares through Medicare, remainder covered by TFL.
Estimated Costs
| Scenario | Estimated Cost |
|---|---|
| ADHD evaluation (Prime ADFM) | $0 with referral |
| Behavioral therapy (Prime ADFM) | $0 with referral |
| Monthly ADHD medication (military pharmacy) | $0 |
| Monthly ADHD medication (retail, generic) | $14 |
| Monthly ADHD medication (retail, brand) | $34 |
Authorization Requirements
Standard ADHD evaluation and treatment typically does not require prior authorization. Some specialty ADHD medications may require prior authorization or step therapy (trying a formulary medication first).
Network & Provider Notes
Behavioral health providers, psychiatrists, and developmental pediatricians in the TRICARE network can diagnose and treat ADHD. Active duty members can self-refer for the first 8 mental health visits.