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Tricare: Disabled Family Members

The Defense Department and the Department of Veterans Affairs have programs that are available to military family members with disabilities. A Tricare initiative called the Extended Care Health Option supplements whatever Tricare plan a sponsor and his family are using.

ECHO, which replaces the Program for Persons with Disabilities, pays up to $2,500 a month for care not otherwise available to active-duty family members with mental disabilities or serious physical disabilities or are homebound because of a severe, complex physical or psychological condition. This includes family members of activated National Guard and Reserve members in the continental U.S. or in a U.S. territory.

Coverage includes medical and rehabilitative care, special education, training in using assistive technology devices, durable equipment, respite care and other services.

Cost shares for covered services are based on paygrade, ranging from $25 for E-1s through E-5s to $250 for O-10s.

The program has several limitations:

å It covers only the family members.

å The beneficiary must register to use ECHO. Registration requires enrollment in the Exceptional Family Member Program. Exceptions are made for some members of the National Guard and Reserve.

å Besides monthly cost shares, military families must pay costs above the $2,500 maximum monthly payment from Tricare. To qualify for the program, a family must document the disability, the doctor’s recommendation for treatment and local treatment facilities.

å A family must first use public programs or public funds that meet ECHO benefits for special education, training, rehabilitation, assistive technology devices, institutional care and transportation to and from those public programs.

Information about the program may be obtained from the appropriate managed care support contractor, Exceptional Family Member Coordinator, Tricare Service Center or a military hospital.

Disabled veterans and certain dependents also may qualify for VA programs.

Contact: http://www.tricare.mil/mybenefit/home/overview/SpecialPrograms/ECHO