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Royal Game of Ur in Military Rehab | TRICARE Guide

Learn how the ancient Royal Game of Ur is used in military cognitive therapy and how TRICARE covers rehabilitation services in 2026.

Royal Game of Ur in Military Rehab | TRICARE Guide

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## Quick answer The Royal Game of Ur is an ancient Mesopotamian board game dating back to 2600 BC. While it has no official therapeutic standing within the TRICARE health system, it is frequently utilized in military medical facilities as a cognitive rehabilitation tool and a socialization strategy for service members recovering from traumatic brain injuries (TBI) or PTSD.

## In detail The Royal Game of Ur is a "race game" played with two sets of seven markers and four-sided (tetrahedral) dice. While it may seem like a simple pastime, its presence in modern military healthcare—specifically within the **Department of Defense (DoD)** and **Veterans Affairs (VA)** recovery centers—serves a clinical purpose.

### Clinical Application in Military Medicine Under the TRICARE benefit structure, recreational therapy and occupational therapy often utilize cognitive-heavy games to help beneficiaries regain executive function. The Royal Game of Ur is used for: * **Cognitive Loading:** Improving memory, pattern recognition, and strategic planning. * **Fine Motor Skills:** Moving small pieces across the 20-square board. * **Social Integration:** Encouraging peer-to-peer interaction among wounded warriors in a low-stress environment.

### Coverage and Costs (2026 Rates) Because the Royal Game of Ur is a tabletop game and not a medical device, TRICARE does not "cover" the purchase of the game for home use. However, the use of the game *during* a covered therapy session is included in the cost of care: * **Active Duty Service Members (ADSMs):** $0 out-of-pocket for occupational therapy sessions where this game might be used. * **TRICARE Select Group A Retirees (2026):** May pay a copayment (historically ~$38 per outpatient visit) for the therapy session itself, during which the game is used as a tool. * **TRICARE Prime:** $0 for most specialist visits with a referral.

### The Role of Regional Contractors Since January 1, 2025, **TriWest Healthcare Alliance** (West Region) and **Humana Military** (East Region) oversee the network providers who may integrate these types of "Serious Games" into rehabilitation protocols. If a beneficiary is receiving care at a military hospital or a specialized brain injury clinic, the game is often provided in common rooms or therapy suites.

## Who this applies to * **Service Members in Rehabilitation:** Those recovering from TBIs at facilities like the National Intrepid Center of Excellence (NICoE). * **Occupational Therapists:** Network providers under Humana Military or TriWest who use board games to measure patient progress. * **Retirees and Veterans:** Individuals utilizing TRICARE for Life or TRICARE Select who participate in community-based socialization programs to combat isolation.

## Common scenarios 1. **TBI Recovery at Walter Reed:** A Sergeant recovering from an IED-related brain injury uses the Royal Game of Ur during an occupational therapy session. Under **TRICARE Prime**, the Sergeant pays **$0 (2026 rates)** for this clinical session, as it is part of their active duty medical care managed by the Defense Health Agency. 2. **Retiree Socialization:** A retired Navy Captain in the West Region (managed by **TriWest**) visits a community mental health provider for PTSD support. The provider uses ancient games to help ground the patient. If the provider is in-network, the Captain pays the standard **TRICARE Select** outpatient copayment for the visit. 3. **Active Duty Family Member (ADFM):** A child of a soldier utilizes the game during a speech and language pathology session to work on turn-taking. Under **TRICARE Select**, the family pays their applicable cost-share based on their sponsor’s status and Group (A or B).

## Related terms * **Occupational Therapy:** A covered TRICARE benefit that helps patients develop, recover, or maintain daily living and work skills. * **Cognitive Rehabilitation:** Therapy aimed at improving mental function after a brain injury, often utilizing puzzles or games. * **TriWest Healthcare Alliance:** The contractor managing the TRICARE West Region as of 2025. * **Humana Military:** The contractor managing the TRICARE East Region. * **Defense Health Agency (DHA):** The joint, integrated Combat Support Agency that enables the Army, Navy, and Air Force medical services to provide a medically ready force.

## Sources * **TRICARE.mil - Covered Services:** https://www.tricare.mil/CoveredServices * **DHA - Traumatic Brain Injury Center of Excellence:** https://health.mil/Military-Health-Topics/Centers-of-Excellence/Traumatic-Brain-Injury-Center-of-Excellence * **Humana Military (East Region):** https://www.humanamilitary.com/ * **TriWest Healthcare Alliance (West Region):** https://www.triwest.com/