TRICARE’s Extended Care Health Option

By Patricia Opong-Brown
TRICARE Management Activity

December 07, 2009: If a family member has special needs, a serious illness or sustains a serious injury, TRICARE has several programs in place to help. For instance, TRICARE has programs to assist a family member with a disability, and to ensure every one of the 9.5 million TRICARE beneficiaries get the best possible care.

The TRICARE Extended Care Health Option (ECHO) provides assistance for active duty family members with physical or mental disabilities. ECHO covers up to $36,000 per fiscal year in addition to regular TRICARE benefits to cover claims for care of a disabled family member. Some of the services ECHO can be used for are: training, rehabilitation, special education (including applied behavioral analysis for the treatment of autism spectrum disorders), institutional care and, under certain circumstances, transportation to and from institutions or facilities. The benefit also includes ECHO Home Health Care, which provides skilled nursing care and other services for severely disabled beneficiaries, and respite care for caregivers.

For a family member to be ECHO-eligible, the sponsor must be an active duty service member and the family member must have a specific physical or mental disability. Children who have moderate or severe mental retardation, serious physical disabilities or are homebound because of their physical or psychological condition may be eligible for ECHO benefits. Selected infants or toddlers diagnosed with a neuromuscular disease may also receive ECHO benefits. Also, children with multiple disabilities may be eligible for ECHO. Some children may remain eligible for ECHO beyond the usual TRICARE upper age limits if the sponsor remains on active duty.

Eligible beneficiaries must be enrolled in the sponsor’s service branch Exceptional Family Member Program (EFMP) and registered with their regional contractor.

If a beneficiary or their health care provider believes a child is qualified for ECHO, he or she can contact a case manager or the regional contractor for more information. If overseas, contact the military treatment facility or TRICARE Area Office. TRICARE ECHO can help reduce the task of taking care of a family member with a disability. For more information about ECHO, or other TRICARE programs, visit http://www.tricare.mil/ECHO.