Extended Care Health Option (ECHO) for special needs

Written by Cmdr. Paul Fawcett

The Extended Care Health Option or ECHO is designed to help families who have a dependent with special needs with additional funding for needed services and supplies. In order to be eligible for the ECHO program you’ll need to register your dependent in the Coast Guard Special Needs Program. You can get more information about the special needs program from the Special Needs Program Website you can also contact your District Work-Life Staff, a phone list is available on the Health, Safety and Work-Life Page. You’ll also have to enroll in the ECHO program with the TRICARE Contractor for your region.

What Conditions does ECHO Cover?

Benefits under the ECHO program are limited to certain defined conditions. These conditions include: Autism Spectrum Disorder (see our previous blog post on this topic), moderate to severe intellectual disability, serious physical disability, extraordinary physical or psychological condition, diagnosis of a neuromuscular condition in an infant or toddler, or multiple disabilities affecting separate systems.

What Services does ECHO Provide?

ECHO provides a range of services and products to help support families with special needs members. These services include: durable medical equipment, special education, incontinence supplies, in home medical services, training in the use of assistive technology, institutional care when residential care is required, and transportation to and from facilities in certain circumstances. Any care or services provided must be from TRICARE authorized providers.

What are Costs and Limitations for ECHO?

ECHO pays for a maximum of $36,000 per year for all products and services combined. There is a cost share per month for ECHO ranging from $25 dollars per month for E1-E5 to a maximum of $250 per month for O-10s. There are no deductibles for ECHO products and services, meaning you won’t be charged any additional fees for the items that you need, beyond your cost share.

Who is Eligible for ECHO?

ECHO is available to Active Duty Family Members, including the family members of reservists activated for over 30 days. Family of a deceased active duty members and family of former military members who were the victims of physical or emotional abuse are also eligible for ECHO.

Respite Care

If you are the primary care giver for a special needs family member you may be eligible for in home respite care. In home respite care is short term care that provides temporary rest for care givers. If your dependent is enrolled in the special needs program and is homebound for their medical condition, you may be eligible for up to 16 hours per month of respite care or up to 40 hours per week if your dependent qualifies for Echo Home Health Care.

Prime Travel Benefit

Don’t forget that that if you have a dependent that requires medical care that requires travel over 100 miles from your doctor’s office, you may be eligible for Prime Travel Benefit to help pay for travel costs. See our previous blog post on this topic. You may combine Prime Travel Benefit for travel expenses, TRICARE Prime for medical expenses and ECHO for additional expenses. You must ensure your eligibility for these programs and enroll properly.

FAQs:

Q: Where can I get more information about the ECHO program.
A: Visit the TRICARE ECHO website.

Q: How do I know what TRICARE Region I’m in?
A: See the below map.

Tricare map

Tricare map

WEST: United Healthcare 1-877-988-WEST (1-877-988-9378) www.uhcmilitarywest.com

SOUTH: Humana Military 1-800-444-5445 www.HumanaMilitary.com

NORTH: Health Net 1-877-TRICARE (1-877-874-2273) www.hnfs.com

For other TRICARE questions you can contact the USCG Health Benefits Assistance line at 1-800-9-HBA-HBA or CGHBA@uscg.mil. You can also leave us a comment below!

 

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