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News | April 6, 2021

What is ECHO and How do I Enroll?

By TRICARE Communications

Are you an active duty service member who has a family member with special needs? Your family member may qualify for the Extended Care Health Option (ECHO). This option is for active duty family members (ADFMs) who need services and supplies beyond what TRICARE plans offer. If your family member has a mental, development, or physical disability, ECHO benefits can help pay for additional treatment and services. It also matches you with resources, training, and more.
 
“From respite care to supplies, active duty families can get extra support through ECHO,” said Carmen DeLeon, a special needs nurse consultant with the TRICARE Health Plan at the Defense Health Agency. “This support can help reduce the disabling effects of a condition or disorder.”
 
Who’s eligible for ECHO
The Extended Care Health Option Fact Sheet lists specific conditions that qualify. More broadly, ECHO is for ADFMs diagnosed with:
  • Moderate or severe intellectual disability
  • Serious physical disability
  • Extraordinary physical or psychological condition
 
You must be enrolled in TRICARE Prime, TRICARE Select, US Family Health Plan, TRICARE Overseas Program (TOP) Prime, or TOP Select. Keep in mind, you also must get pre-authorization from your TRICARE contractor for all ECHO services. And a TRICARE-authorized provider must provide these services. This means TRICARE doesn’t pay for services provided by family members, trainers, or other individuals who aren’t TRICARE-authorized providers.
 
What are the benefits
With ECHO, your family member will gain access to a number of products and services. Some ECHO benefits include:
  • Durable equipment
  • Training
  • Rehabilitation
  • Special education
  • Home health care
  • Respite care for the primary caregiver
 
There are monthly costs for authorized ECHO benefits. You pay monthly copayments based on the sponsor’s pay grade, but only for the months you use ECHO benefits. The coverage limit is $36,000 per calendar year and per beneficiary. This doesn’t include the ECHO Home Health Care benefit. You can learn more about costs and coverage limits by checking out this ECHO page.
 
How to enroll
First, your information must be up to date in the Defense Enrollment Eligibility Reporting System (DEERS).
 
“Make sure all your information is up to date in DEERS,” said DeLeon. “This gives the TRICARE regional contractors current information, so an ECHO representative can contact you as needed to access the ECHO benefit.”
 
If eligible, you also need to:  
After you’re enrolled in ECHO, you’ll get a case manager. Your case manager will help you find providers, get care, and make the most of your TRICARE benefit.
 
Depending on your region, you can reach out to your TRICARE contractor for additional enrollment information:
  • In the East Region, call Humana Military:
    • Medical inquiries: 1-800-881-9227
    • Behavior Health inquiries: 1-866-323-7155
 
Keep in mind, ECHO registration is required for ADFMs to qualify for services through the Comprehensive Autism Care Demonstration (ACD). For the latest on the ACD, read about these new ACD changes.
 
To learn more about ECHO, check out the ECHO page and the Extended Care Health Option Fact Sheet. If you need help with ECHO benefits or want to see if your family qualifies, be sure to talk your TRICARE contractor. Take command of your health and get the support your family needs.
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