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Respite Care Benefit for Seriously Ill or Wounded Active Duty Members
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Beginning October 24, 2008, the Respite Care Benefit for Active Duty Service Members (ADSM) will be implemented. The benefit is effective back to January 1, 2008. ADSMs who qualify for the benefit may be reimbursed for any out-of-pocket cost associated with receiving respite care services from January 1 2008 forward. No cost shares or co-pays apply when the services are approved by the appropriate authority.
What is Respite Care?
Respite care is short-term care provided by a TRICARE-authorized Home Health Agency (HHA) for an eligible ADSM in order to provide rest and change for the primary caregiver(s) who have been caring for the seriously ill or wounded active duty member at home.
Qualifications for the Benefit
ADSMs may qualify for the benefit it they have a serious injury or illness resulting in, or based on the clinical assessment of the member’s provider or case management team that identifies a physical disability or an extraordinary physical or psychological condition which results in the member being homebound, and leaving home would require considerable and taxing effort. The MTF, MMSO, SPOC or TAO will determine the beneficiary‘s qualifications for respite.
Maximum Allowable Hours
Eligible ADSMs can receive a maximum of 40 respite hours in a calendar week; no more than 5 days per calendar week; and no more than 8 hours per calendar day.
For more information about the benefit, please refer to the TRICARE Operations Manual Chapter 18, Section 3 and Addendum C. |
