Digital Therapeutics Apps Covered by TRICARE

 

A four-panel digital comic strip features a male service member and a female healthcare provider discussing TRICARE’s new coverage for digital therapeutic apps. Panel 1: The service member says, 'I heard TRICARE covers some new apps...' and the provider replies, 'Yes, digital therapeutics for mental or chronic health conditions.' Panel 2: He asks, 'They really prescribe apps now?' She responds, 'It’s a new option alongside meds and therapy.' Panel 3: He asks, 'What’s an example, like for insomnia?' She replies, 'One app is for sleep problems from PTSD.' Panel 4: He says, 'That sounds helpful. How do I get one?' She answers, 'As long as you qualify, I’ll send in a request.'"

Digital Therapeutics Apps Covered by TRICARE

As digital health continues to evolve, more TRICARE beneficiaries—active duty members, veterans, and dependents—are gaining access to FDA-cleared digital therapeutics (DTx) apps as part of their covered benefits.

These clinically validated apps go far beyond fitness trackers or meditation tools—they deliver evidence-based interventions via smartphones or tablets and are prescribed just like medications or physical therapy.

With TRICARE recognizing the value of digital tools in behavioral health, chronic disease management, and neurological conditions, a new era of accessible, at-home treatment is emerging for military families.

📌 Table of Contents

What Are Digital Therapeutics (DTx)?

Digital therapeutics are software-based treatments designed to prevent, manage, or treat medical conditions. They require clinical evidence, regulatory clearance, and often a prescription from a provider.

Unlike generic wellness apps, DTx solutions are developed through rigorous clinical trials and reviewed by the FDA for efficacy and safety—especially in fields like behavioral health, cardiology, diabetes, and insomnia.

Many DTx apps are part of value-based care models, offering outcomes-based reimbursement and real-time data monitoring.

How TRICARE Evaluates and Covers DTx

TRICARE may cover a digital therapeutic if it:

  • Is FDA-cleared or approved
  • Is deemed medically necessary by a TRICARE-authorized provider
  • Has a valid HCPCS or CPT billing code
  • Is used to treat a covered condition (e.g., PTSD, diabetes, chronic pain)

Coverage decisions are made regionally through Managed Care Support Contractors (Humana Military, Health Net Federal Services), and pre-authorization may be required.

Top DTx Apps Covered by TRICARE

Some digital therapeutics currently eligible or under review for TRICARE reimbursement include:

  • reSET® and reSET-O® (by Pear Therapeutics): Prescription DTx for substance use disorder and opioid use disorder.
  • EndeavorRx® (by Akili Interactive): FDA-authorized for ADHD in children aged 8–12.
  • Somryst®: Digital CBT for chronic insomnia in adults, especially effective for PTSD-related sleep disorders.
  • DarioHealth®: Remote diabetes and hypertension monitoring platform with DTx integration.
  • Kaia Health®: App-based back pain and musculoskeletal therapy.

These apps must be prescribed and dispensed via digital pharmacy partners (like TruLeafRx or PhilRx) and documented in the patient’s EHR for TRICARE billing.

How to Access a DTx App Through TRICARE

To start using a digital therapeutic through TRICARE:

  1. Consult with your TRICARE-authorized provider (e.g., military treatment facility or network civilian doctor).
  2. If medically appropriate, they will prescribe the DTx solution with proper documentation.
  3. The prescription is filled through a digital or specialty pharmacy contracted with TRICARE.
  4. Access instructions and support are provided via email or app store download.

Patient education and provider follow-up are often built into the platform to improve adherence.

Benefits for Military Families and Veterans

DTx tools offer several unique advantages to TRICARE families:

  • Remote access to care from anywhere in the world
  • No stigma associated with visiting behavioral clinics in person
  • Support for pediatric ADHD, insomnia, PTSD, and substance use—all common in military populations
  • Integration with wearable devices and EHRs

With outcomes-driven design and growing policy support, DTx apps are reshaping care delivery for service members and their families.

📎 Trusted External Resources

Keywords: TRICARE digital therapeutics, DTx apps military, reSET-O coverage, ADHD therapy TRICARE, veteran digital health benefits