After your kiddo is enrolled in the Exceptional Family Member Program (EFMP), you can then enroll her into the Extended Care Health Option (ECHO). This is the supplement that provides for a short list of benefits, including getting the necessary ABA service that should be most effective for your child. Every service does their enrollment into EFMP differently, but ECHO benefits are the same across the uniformed services.
Hope this helps!
You can link to the following on the Tricare Fact Sheet for ECHO by clicking here…
The Extended Care Health Option (ECHO) is a supplemental program to the TRICARE Basic benefit. ECHO provides eligible active duty family members with an additional financial resource for services and supplies designed to help reduce the disabling effects of a beneficiary’s qualifying condition.
ECHO has no enrollment fee, however; you must register for ECHO to receive ECHO benefits. Registration in ECHO requires the beneficiary be enrolled in the Exceptional Family Member Program (EFMP) as provided by the sponsor’s branch of service. There is no enrollment fee for the EFMP.
ECHO benefits are available to the following dependents with a qualifying condition:
* TRICARE eligible dependents of members of the uniformed services, including members of the National Guard and Reserves activated for more than 30 days;
* Family members eligible for continued TRICARE medical benefits through the Transitional Assistance Management Program (TAMP);
* Children or spouses of former members of the Uniformed Service who were victims of physical or emotional abuse;
* Family members of a deceased active duty sponsor remain eligible for ECHO benefits during the period they are in transitional survivor status.
Qualifying conditions for ECHO include:
* Moderate or severe mental retardation;
* A serious physical disability;
* A physical or psychological condition that causes the beneficiary to be homebound
Children may remain eligible for ECHO benefits beyond the usual TRICARE eligibility age limit (21 or age 23 if enrolled in college full time) provided the sponsor remains on active duty, the child is incapable of self-support because of a mental or physical incapacity that occurs prior to the loss of their eligibility, and the sponsor is responsible for more than one-half the child’s support.
Benefits provided under ECHO may include any of the following:
* Medical and rehabilitative services;
* Training to use assistive technology devices;
* Special education;
* Institutional care when a residential environment is required;
* Transportation under certain circumstances;
* Assistive services, such as those from a qualified interpreter or translator, for beneficiaries whose visual or hearing impairment qualifies them for ECHO benefits;
* Durable equipment, including adaptation and maintenance of beneficiary-owned equipment;
* In-home medical services;
* In-home respite care services
* Beneficiaries who are homebound may qualify for the ECHO Home Health Care (EHHC) benefit in addition to other ECHO benefits.
Coverage Limit and Government/Sponsor Liability
The Government’s limit for the cost of all ECHO benefits combined, excluding the EHHC, is $36,000 per beneficiary, per fiscal year (October 1–September 30).
ECHO-allowable amounts are not subject to a deductible. The cost-share for every month beneficiaries use ECHO benefits is based on the sponsor’s pay grade, as shown in the following table:
ECHO Cost-Share Amounts
Sponsor Pay Grade
Sponsor Cost-Share Amount
E-1 through E-5: $25.00
E-7 and 0-1: $35.00
E-8 and 0-2 $40.00
E-9, WO/WO-1, $45.00
CWO-2, and 0-3:
CWO-3, CWO-4, $50.00
CWO-5, 0-5: $65.00
For more information on ECHO, visit the TRICARE website at www.tricare.mil/echo, or contact your regional contractor. For more information about EFMP, beneficiaries may visit the Military Homefront Web site at www.militaryhomefront.dod.mil. You may also call TRICARE Regional Offices North (1-877-874-2273); South (1-800-444-5445); West (1-888-874-9378). If you are overseas, click here for country-specific toll-free contact information.