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TRICARE ECHO: For Your Special Needs

TRICARE ECHO provides financial assistance to active duty family members (ADFMs) with specific mental or physical disabilities. It offers an integrated set of services and supplies not available through the basic TRICARE program options (e.g., TRICARE Prime, TRICARE Standard, TRICARE Reserve Select).
 

Who is eligible?  Leaving Site

TRICARE ECHO is only available to ADFMs with qualifying conditions, including:
  • Autism spectrum disorders*
  • Diagnosis of a neuromuscular developmental condition/other condition in an infant/toddler expected to precede a diagnosis of moderate/severe mental retardation or serious physical disability
  • Extraordinary physical/psychological condition rendering the beneficiary homebound
  • Moderate/severe mental retardation
  • Multiple disabilities (may qualify if there are two or more affecting separate body systems)
  • Serious physical disability
* Effective March 15, 2008, TRICARE introduced the Department of Defense Enhanced Access to Autism Services Demonstration, which provides a greater range of existing evidence-based services (e.g., Applied Behavior Analysis) for ADFMs diagnosed with autism spectrum disorders. To qualify, ADFMs must be at least 18 months old, enrolled in the Exceptional Family Member Program (EFMP), registered for TRICARE ECHO, and live in the 50 United States or the District of Columbia.

ECHO Benefits

For those who qualify, TRICARE ECHO provides benefits not available through the basic TRICARE program, including:
  • Assistive services (e.g., those from a qualified interpreter or translator)
  • Durable equipment, including adaptation and maintenance
  • Expanded in-home medical services through TRICARE ECHO Home Health Care (EHHC)
  • Medical and rehabilitative services
  • In-home respite care services (one benefit per calendar month only)
    • ECHO Respite care—16 hours per month when receiving other authorized ECHO benefits
    • EHHC Respite care—up to 40 hours per week (eight hours per day, five days per week) for those who qualify
    • Training to use assistive technology devices
    • Institutional care when a residential environment is required
    • Special education (this does not include tuition for a beneficiary to attend private schools)
    • Transportation under certain circumstances for institutionalized ECHO beneficiaries

How to Use ECHO

  • For Behavioral Health qualifying disorders, register with a ValueOptions case manager.
  • For Medical qualifying disorders or diagnosis, register with your Humana Military case manager.
  • Use public funds and facilities first. Many communities offer funds or programs for people with disabilities. If adequate public assistance is not available, you must include a Public Facility Use Certification letter from the proper public official explaining why public assistance is unavailable or insufficient with your request for benefits.
  • Obtain prior authorization: All TRICARE ECHO benefits must be authorized in advance.
  • Select TRICARE providers: All services, supplies, and equipment must be received from a TRICARE-authorized provider. Beneficiaries enrolled in a TRICARE Prime option who receive TRICARE ECHO benefits must also comply with their program’s requirements (e.g., use a primary care manager for routine care and obtain referrals for specialty care).

What does it cost?

Sponsors must pay part of the monthly expenses for ADFMs to receive authorized ECHO benefits. Cost-shares are based on the sponsor’s pay grade and are separate from your TRICARE program option cost-shares. Contact a case manager for specific benefit information. Note: ECHO cost-shares do not accrue toward the catastrophic cap.
 
Learn more from TRICARE Leaving Site


For Information and Assistance:

For behavioral health disorders, please contact ValueOptions at 866-323-7155.

For medical diagnosis including ECHO Home Health Care:
      
Southwest Division Southeast Division

(800) 615-7332

(877) 411-9796

Texas (excluding the El Paso Area)
Louisiana
Oklahoma
Arkansas
Mississippi (excluding Columbus AFB)
Mobile, AL
Millington, TN
Florida panhandle
Ft. Campbell, KY
Tennessee (excluding Millington, TN)
Alabama (excluding Mobile, AL)
Georgia
Columbus AFB, MS
South Carolina
Florida (excluding the panhandle)


Reference Materials

All files are posted as PDFs unless otherwise noted.

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Last Update: August 01, 2014