TriCare Extended Care Health Option (ECHO)
The TriCare Extended Care Health Option (ECHO) replaces the Program for Persons with Disabilities (PFPWD).
The TriCare ECHO program provides financial assistance beyond basic TriCare programs for beneficiaries who qualify and is administered by TriCare Regional Contractors. Qualifying conditions include:
- Moderate to severe developmental delay
- Serious physical disability
- An extraordinary physical or psychological condition of such complexity that the beneficiary is homebound.
The ECHO program is designed to step in and cover needed services over and above those covered by traditional TriCare programs such as therapies, special education, specialized medical equipment, home health services, etc. when unavailable to the service member and their dependents in their community. Benefit coverage/spending is subject to a yearly cost/spending cap and does vary. Coverage is dictated by Congress and the year. Many families may find themselves prioritizing and choosing between needed benefits and services in order to stay under the fiscal year spending cap. Check with your TriCare case manager for the amount allowable for the fiscal year.
There are several specific requirements that must be followed in order to enroll in the TriCare ECHO program. Discuss these requirements with your assigned Case Manager or an EFMP Special Needs Coordinator located at your MTF if you believe you qualify.
*Note for Reservists and National Guard Members. Families who are on limited Active Duty orders may find the ECHO program does not meet medical benefit needs already met by Medicaid Waiver programs. Medicaid DOES supersede ECHO in most cases. Linda's family has been enrolled in the ECHO program 4 separate times and has yet to see ECHO pay out for any listed benefit. By maintaining enrollment in their state Medicaid Waiver program the family has been able to ensure continuity of medical service and care without loss of benefits upon return to part-time status from active duty/Title 10/Title 32.