TRICARE Provider News image

Adobe PDF print image Print


TRICARE Extended Care Health Option (ECHO)—A Program Recap 
(Article 4)

On Sept. 1, 2005, TRICARE’s Extended Care Health Option (ECHO) replaced the TRICARE Program for Persons with Disabilities (PFPWD). The new ECHO program expands upon the financial assistance delivered to active duty family member beneficiaries who have a qualifying condition as defined by the law. It also continues to offer—and in some instances expands—services and supplies that supplement the basic TRICARE Prime, TRICARE Standard and TRICARE Extra program options. While there are many similarities between PFPWD and ECHO, the government’s monthly cost-share has increased from $1,000 to $2,500. Depending on the circumstances, ECHO benefits may include medical and rehabilitative services; training to use adaptive technology devices; special education; institutional care; transportation; services, such as those from a qualified interpreter or translator; durable equipment; expanded in-home medical service through TRICARE ECHO Home Health Care (EHHC); in-home respite care services, including ECHO and EHHC; and
Applied Behavioral Analysis (ABA).


TRICARE ECHO Eligibility

TRICARE ECHO is only available to active duty family members who have a qualifying condition. 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; a diagnosis of a neuromuscular developmental condition or other condition in an infant or toddler that is expected to precede a diagnosis of moderate or severe mental retardation or a serious physical disability; and multiple disabilities, which may qualify if there are two or more disabilities affecting separate body systems.

Additionally, participants must register in the Exceptional Family Member Program (EFMP) to be eligible for ECHO. To learn about EFMP, visit the DoD's Military Homefront web site.


Find More Information

Additional information about the new TRICARE ECHO program is available on the TRICARE Web site or the Online Beneficiary Answer Place. Prior to Sept. 1, PFPWD participants should have received letters explaining the change from PFPWD to ECHO. If you believe that one of your patients has a condition that may qualify for services under TRICARE ECHO, contact Humana Military at 1-800-444-5445 for assistance.
 


Contacts  (Article 5)
Humana Military
1-800-444-5445 
www.humana-military.com 
Pharmacy Customer Service
1-866-DoD-TRRx (retail)
1-866-DoD-TMOP (mail order)
www.express-scripts.com/TRICARE

ValueOptions (behavioral health)
1-800-700-8646

National TRICARE Web Sites
www.tricare.osd.mil
www.tricareonline.com

Update DEERS
1-800-538-9552
http://www.tricare.osd.mil/deers/default.cfm

PGBA (claims)
1-800-403-3950
 


Back to Top