# Stop Copay Overpay Act: What It Means for Military Families

This bill makes mental health care more affordable for military families and retirees who use TRICARE, the military's health insurance program. Right now, people covered by TRICARE sometimes pay higher copayments for mental health visits than they do for regular doctor visits, even though both are important medical services. This bill caps those mental health copayments so they can't be more than what someone would pay for a primary care visit.

Here's what that means in practice: If your copayment for seeing your regular doctor is $20, you won't have to pay more than $20 to see a mental health specialist or therapist through TRICARE, no matter what type of mental health provider you visit. This applies to active-duty service members, retirees, their families, and anyone else enrolled in TRICARE. The change takes effect immediately when the bill becomes law and applies to all mental health visits going forward.

The bill also includes a temporary one-year freeze on copayment increases for other specialty care services (like seeing a cardiologist or dermatologist). During this year, the military can't raise what you pay for specialty care beyond what it cost in 2021. After that year ends, the military could potentially raise those copayments again, but the bill requires the Secretary of Defense to report back to Congress about whether the mental health copayment cap might cause problems in the military health system that would need to be fixed.

The practical effect is that military families will have easier access to mental health care without worrying about being hit with unexpectedly high bills, which could encourage more people to seek the mental health support they need.

Stop Copay Overpay Act

Stop Copay Overpay Act This bill prohibits the Department of Defense (DOD) from charging a covered individual (i.e., individuals enrolled under the TRICARE program) a co-payment exceeding a certain rate for an outpatient visit for mental health or behavioral health under the TRICARE program, regardless of whether the visit is furnished by a specialty care provider. Specifically, the co-payment amount may not exceed the amount of a co-payment that would be charged under the TRICARE program for an outpatient visit for primary care services. During the one-year period after this bill is enacted, DOD may not increase the co-payment amount charged to a covered individual for any service (1) furnished by a specialty care provider under the TRICARE program, and (2) that is not mental or behavioral health care.