Benefits

If you are eligible for long-term care, you may be covered under the Extended Care Health Option (ECHO). ECHO benefits include:

• Training
• Rehabilitation
• Special education
• Assistive technology devices
• Institutional care in private nonprofit, public and state facilities (may include transport to and from)
• Home health care
• Respite care for the primary caregiver
• Incontinence supplies (diapers); You may need to file your claim. Contact your case manager for more details.

All ECHO benefits must be

• Authorized in advance, and
• From a TRICARE-authorized providerAn authorized provider is any individual, institution/organization, or supplier that is licensed by a state, accredited by national organization, or meets other standards of the medical community, and is certified to provide benefits under TRICARE. There are two types of TRICARE-authorized providers: Network and Non-Network. DS

Some services may be cost-shared under ECHO or your basic TRICARE program. This includes services needed to establish or confirm the severity of a qualifying condition or measure functional loss.

Do you want to change providers? You must get a new benefit authorization from your regional contractor.

Home Health Care

Do you need home health care? ECHO Home Health Care (EHHC) provides medically necessaryTo be medically necessary means it is appropriate, reasonable, and adequate for your condition. skilled services to you if you:

• Are homeboundTRICARE considers you homebound if you can’t leave your home without a lot of effort.
• Need more than 28-35 hours per week of home health services or respite care

The EHHC benefit is only available in the United States and U.S. Territories. >>Learn more

Respite Care for Primary CaregiversAnyone who takes care of the patient at home and helps with daily activities.

Are you a primary caregiver? You may qualify for in-home respite care:

• Up to 16 hours of in-home respite care per month or
• 40 hours per week (8 hours per day, 5 days a week) if the child qualifies for EHHC

You can't use them together.

TRICARE covers ECHO Respite care even when a primary caregiver or family member isn’t present when care is given. Respite care is only available in the United States and U.S. Territories. 

Public Funds and Programs

Many communities offer public funds or programs for persons with disabilities. You must use these resources first if they're available and sufficient:

• Training
• Rehabilitation
• Special education
• Assistive technology devices
• Institutional care in private nonprofit, public and state facilities (may include transport to and from)

What if resources aren't available? You must include a Public Facility Use Certificate with your ECHO benefits request from the proper public official. They must explain why the resources aren't available or sufficient.