ECHO Benefits

• ABA therapy (which includes the DoD Enhanced Access to Autism Services Demonstration, discussed later in this section) and other types of special education (which may include ABA but excludes education the school system is responsible for) that are not available through local community resources
• 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)
• Rehabilitative services
• Respite care (during any month when at least one other ECHO benefit is received and limited to the United States, Guam, Puerto Rico, and the U.S. Virgin Islands)
  • ECHO respite care: Up to 16 hours of care
  • EHHC respite care: Up to eight hours per day, five days per week
• Training to use special education and assistive technology devices
• Institutional care when a residential environment is required
• Transportation under certain limited circumstances (i.e., to and from institutions or facilities to receive otherwise-allowable ECHO benefits)

TRICARE may pay for “hands-on” ABA services provided by TRICARE-authorized providers. However, TRICARE does not pay for services provided by family members, trainers, or other individuals who are not TRICARE-authorized.

Note: All ECHO services require prior authorization from Humana Military. Refer to the Health Care Management and Administration section of this handbook for information about ECHO prior authorization requirements in the South Region.
      

ECHO Costs

The government’s limit for the cost of ECHO services combined (excluding EHHC) is $36,000 per beneficiary, per FY. Beneficiaries are responsible for ECHO cost-shares in addition to cost-shares for basic TRICARE benefits (e.g., under TRICARE Prime, TPRADFM, TRICARE Standard and TRICARE Extra). ECHO cost-shares do not count toward the catastrophic cap. EHHC costs do not count toward ECHO yearly maximum cost-shares.

For more information about ECHO, refer to the TRICARE Policy Manual, Chapter 9, or visit TRICARE's ECHO web portal. You may also call Humana Military at 1-800-444-5445 or visit the ECHO web page. To learn more about ECHO benefits in your area, contact your local ECHO case manager:

• Arkansas, Louisiana, Oklahoma, and Texas (except the El Paso area): 1-800-447-8808
• Florida (except the panhandle), Georgia, and South Carolina: 1-800-447-6072
• Mississippi, Alabama, Tennessee, New Orleans area, and Florida Panhandle: 1-866-323-7155