Extended Care Health Option
The Extended Care Health Option or ECHO is a supplemental coverage program offered by TRICARE to dependents of members of the uniformed services of the United States with a qualifying disability.
Eligibility
ECHO benefits are available with a qualifying condition to a TRICARE-eligible child or spouse of an active duty uniformed service member.The following are qualifying conditions under ECHO:
- A serious physical disability
- Moderate or severe mental retardation
- An extraordinary physical or psychological condition of such complexity that the beneficiary is homebound
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 Program 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.
Coverage
In addition to coverage received via the primary TRICARE plan, TRICARE ECHO benefits may include:- Special education
- Medical and rehabilitative services
- Transportation under certain circumstances
- Training to use assistive technology devices
- Institutional care when a residential environment is required
- 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
- In-home respite care services
- *ECHO Respite care-16 hours per month when receiving other authorized ECHO benefits
- *EHHC Respite care-up to 40 hours per week if homebound
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 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.