FALLS CHURCH, Va. -- Are you aware of the Extended Care Health Option (ECHO)? This TRICARE option is available for eligible active duty family members (ADFMs) with special needs. It offers health care benefits beyond what other TRICARE plans offer. ECHO benefits include extra treatment, services, and more. To learn more about this program, check out the Extended Care Health Option Fact Sheet. This fact sheet offers an overview of the care your family members may be eligible to receive through ECHO.
“TRICARE resources like the Extended Care Health Option Fact Sheet provide information to help you get the most from your health care benefits,” said Robert Agnello, deputy chief of Digital Communications at the Defense Health Agency. “Review this fact sheet to see if ECHO is the right option for your family.”
Here’s a look at some things you can learn about ECHO eligibility, enrollment, benefits, and costs.
1. Who qualifies for ECHO?
There are specific conditions that determine whether a family member qualifies for ECHO coverage. The “ECHO Eligibility” section outlines most of them. Some examples of qualifying conditions include:
- Autism Spectrum Disorder
- Moderate to severe intellectual disability
- Serious physical disability
- Multiple disabilities affecting separate body systems
As highlighted in the fact sheet, your ADFM with a qualifying condition must also be enrolled in one of the following TRICARE health plans to qualify for ECHO:
2. How do you enroll in ECHO?
The fact sheet outlines the steps active duty sponsors must take to be eligible for ECHO benefits. For example, active duty sponsors with family members who need ECHO benefits must sign up for their service’s Exceptional Family Member Program (unless waived in specific situations). You must also register for ECHO with your TRICARE regional contractor. There’s no retroactive registration. This means you have to get pre-authorization from your regional contractor for all ECHO services.
3. What does ECHO cover?
In the “ECHO Benefits” section, the fact sheet outlines what ECHO covers. Some of the covered products and services include:
- Durable medical equipment
- Assistive services, like an interpreter or translator
- Rehabilitative services
- Respite care for the primary caregiver
- Institutional care when required
- Training in special education and assistive technology devices
4. What are ECHO costs?
There are no enrollment fees for ECHO. But you do have monthly copayments for the months you use ECHO benefits. You pay monthly copayments based on the sponsor’s pay grade. The copayments range from $25 to $250, as outlined in the fact sheet. The coverage limit for all ECHO benefits combined is $36,000 per family member, per calendar year. This coverage limit excludes the ECHO Home Health Care benefit.
Your TRICARE contractor can provide further help if you have questions about ECHO enrollment, benefits, or costs. After you review the ECHO fact sheet, take the publications survey to share your feedback.
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