Extended Care Health Option
Encyclopedia
TRICARE
TRICARE, formerly known as the Civilian Health and Medical Program of the Uniformed Services , is a health care program of the United States Department of Defense Military Health System. TRICARE provides civilian health benefits for military personnel, military retirees, and their dependents,...
to dependents of members of the Uniformed services of the United States
Uniformed services of the United States
The United States has seven federal uniformed services that commission officers as defined by Title 10, and subsequently structured and organized by Title 10, Title 14, Title 33 and Title 42 of the United States Code.-Uniformed services:...
with a qualifying disability
Disability
A disability may be physical, cognitive, mental, sensory, emotional, developmental or some combination of these.Many people would rather be referred to as a person with a disability instead of handicapped...
.
Eligibility
ECHO benefits are available with a qualifying condition to a TRICARETRICARE
TRICARE, formerly known as the Civilian Health and Medical Program of the Uniformed Services , is a health care program of the United States Department of Defense Military Health System. TRICARE provides civilian health benefits for military personnel, military retirees, and their dependents,...
-eligible child or spouse of an active duty uniformed service
Uniformed services of the United States
The United States has seven federal uniformed services that commission officers as defined by Title 10, and subsequently structured and organized by Title 10, Title 14, Title 33 and Title 42 of the United States Code.-Uniformed services:...
member.
The following are qualifying conditions under ECHO:
- Moderate or severe mental retardation
- A serious physical disability
- An extraordinary physical or psychological condition of such complexity that the beneficiary is homebound
ECHO Enrollment/Registration
TRICARE ECHO requires all eligible beneficiaries do the following:- Present evidence that the sponsor is an active duty service member in one of the Uniform Services.
- Enroll in the Exceptional Family Member ProgramExceptional Family Member ProgramThe Exceptional Family Member Program or EFMP is a mandatory U.S. Department of Defense enrollment program that works with other military and civilian agencies to provide comprehensive and coordinated community support, housing, educational, medical, and personnel services worldwide to U.S...
(EFMP) that is available through their service branch. - Submit the required Enrollment Forms: DD Form 2792 Exceptional Family Member Medical Summary, DD Form 2792-1 Exceptional Family Member Special Education/Early Intervention
- Register with their regional contractor to obtain ECHO benefit authorization.
For more information about the EFMP, Department of Defense
United States Department of Defense
The United States Department of Defense is the U.S...
beneficiaries may visit the Military Homefront Website. U.S. Coast Guard
United States Coast Guard
The United States Coast Guard is a branch of the United States Armed Forces and one of the seven U.S. uniformed services. The Coast Guard is a maritime, military, multi-mission service unique among the military branches for having a maritime law enforcement mission and a federal regulatory agency...
beneficiaries should contact their regional Work-Life office to inquire about the Coast Guard Special Needs Program.
Coverage
In addition to coverage received via the primary TRICARE plan, TRICARE ECHO benefits may include:- Medical and rehabilitative services
- Training to use assistive technology devices
- Special education
- Institutional care when a residential environment is required
- Transportation under certain circumstances
- Assistive services, such as those from a qualified interpreter or translator, for beneficiaries whose visual or hearing impairment qualifies them for ECHO benefits
- Durable equipment, including adaptation and maintenance
- In-home medical services through TRICARE ECHO Extended Home Health Care (EHHC)
- In-home respite care services (Note: Only one of the following respite care benefits may be used in a calendar month.)
- ECHO Respite care-16 hours per month when receiving other authorized ECHO benefits
- EHHC Respite care-up to 40 hours per week (eight hours per day, five days per week) if homebound
Coverage limitations
The ECHO benefit provides a government cost-share limit of $2,500 per month, per eligible family member. In addition to other TRICARE ECHO benefits, beneficiaries who are homebound may qualify for extended in-home health care services. The $2,500 cost share does not apply to the ECHO Home Health Care (EHHC) as there is a benefit cap.For certain benefits, ECHO requires recipients to first use public funds and facilities to the extent that they are available and adequate.
Under ECHO, sponsors must pay part of the monthly authorized expenses for their family members, based on their pay grade, ranging from $25 to $75 a month for all enlisted and most officers.