The Extended Care Health Option (ECHO) provides financial assistance to beneficiaries with special needs for an integrated set of services and supplies.
To use ECHO, qualified beneficiaries must:
The following beneficiaries who are diagnosed with moderate or severe mental retardation, a serious physical disability, or an extraordinary physical or psychological condition may qualify for ECHO:
Children may remain eligible for ECHO benefits beyond the usual TRICARE eligibility age limit (age 21 or age 23 if enrolled in a full-time course of study at an approved institution of higher learning and if the sponsor provides over 50 percent of the financial support) provided all of the following are true:
ECHO provides coverage for the following products and services* :
TRICARE does not pay for services provided by family members, trainers, or other individuals who are not TRICAREauthorized.
* All ECHO services require prior authorization from your regional contractor or TAO director overseas.
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:
|Sponsor Pay Grade||Cost Share Amount|
|E-1 throught E-5||
|E-7 and O-1||$35|
|E-8 and O-2||$40|
|E9, WO/WO-1, CWO-2, and O-3||$45|
|CWO-3, CWE-4, and O-4||$50|
See the TRICARE ECHO Website for more details.