Extended Care Health Option

The Extended Care Health Option provides additional assistance to beneficiaries with special needs for an integrated set of services and supplies.

Using ECHO

To use ECHO, qualified beneficiaries must:

• Be enrolled in the Exceptional Family Member Program through the sponsor’s service. Sometimes, enrollment in the EFMP may be waived — for example, when the sponsor’s service doesn’t provide the EFMP, or when the beneficiary resides with the custodial parent who isn’t the active duty sponsor. Contact your regional contractor or US Family Health Plan designated provider for more information.
• Register for ECHO with case managers in their TRICARE region or through their USFHP designated provider. (Note: There’s no retroactive registration for ECHO.)

The qualifying family member’s disability must be entered properly in the Defense Enrollment Eligibility Reporting System(DEERS) A database of information on uniformed services members (sponsors), U.S.-sponsored foreign military, DoD and uniformed services civilians, other personnel as directed by the DoD, and their family members. You need to register in DEERS to get TRICARE. to have access to ECHO services.

You must get pre-authorization from your regional contractor or USFHP designated provider for all ECHO services.

Who’s Eligible

Eligibility for ECHO is based on the family member’s beneficiary type, TRICARE plan, and condition.

Beneficiary type	ECHO benefits are available to the following beneficiaries with a qualifying condition: Active duty family members Family members of activatedCalled or ordered to active duty service for more than 30 days in a row. National Guard or Reserve members Family members who eligible for continued coverage under the Transitional Assistance Management Program Children or spouses of former service members who are victims of physical and emotional abuse and qualify for the Transitional Compensation Program Family members of deceased active duty sponsors while they’re considered transitional survivors.
TRICARE plan	The family member must be enrolled in one of the following TRICARE plans: TRICARE Prime TRICARE Select TRICARE Prime Overseas TRICARE Select Overseas US Family Health Plan
Examples of qualifying conditions	Conditions to qualify for ECHO coverage may include, but aren’t limited to: Autism spectrum disorder Moderate or severe intellectual disability Serious physical disability Extraordinary physical or psychological condition of such complexity that the beneficiary is homeboundTRICARE considers you homebound if you can’t leave your home without a lot of effort. Diagnosis of a neuromuscular developmental condition or other condition in a child under age 3 that is expected to precede a diagnosis of moderate or severe intellectual disability or a serious physical disability Multiple disabilities, which may qualify if there are two or more disabilities affecting separate body systems

Are there age limits?

Children may remain eligible for ECHO beyond the usual TRICARE age limits in some circumstances. All of the following must be true: 

• The sponsor remains on active duty.
• The child is incapable of self-support because of a mental or physical incapacity that occurs before the loss of eligibility.
• The sponsor is responsible for over 50% of the child’s financial support.

Do you or your provider believe a qualifying condition exists? Talk to a case manager or with your regional contractor or USFHP designated provider to determine eligibility for ECHO benefits.

Benefits

ECHO Benefits ECHO Home Health Care Costs and Coverage Limits

Contact Information

If you need help with ECHO benefits or want to see if you qualify, contact your contractor:

East Region	Humana Military 800-444-5445
West Region	TriWest Healthcare Alliance 888-TRIWEST (874-9378)
US Family Health Plan	Member Services Representative USFHP contact information
Overseas Region	International SOS Country-specific toll-free numbers