Extended Care Health Option Benefits
Extended Care Health Option (ECHO) provides additional services and supplies that are not available through the basic TRICARE program. Below is a list of benefits that may be available under the ECHO program depending on the ECHO qualifying condition. This information can also be found on TRICARE's ECHO Benefits page.
- medical and rehabilitative services not specifically covered under the basic TRICARE benefit
- incontinence supplies or diapers may be covered for beneficiaries age three and older who are incontinent as a result of spinal, neurologic and/or mobility issues
- training (for example, how to use assistive technology devices such as a specialized computer keyboard)
- vocational support such as classes that teach a beneficiary to become more independent with life skills
- family training to assist in the management of the beneficiary’s qualifying condition – for example, training a family member to use the ECHO beneficiary’s specialized equipment and alternative communication methods
- institutional care when the severity of the qualifying condition requires protective custody or training in a residential environment
- private transportation to and from an ECHO-authorized service for institutionalized ECHO beneficiaries – for example, mileage reimbursement to transport the institutionalized ECHO beneficiary to and from an ECHO-authorized service
- assistive services, such as those from a qualified interpreter or translator for beneficiaries who are deaf or mute – for example, readers for the blind and sign language interpreters to assist in receiving authorized ECHO services
- durable equipment that is essential to reducing functional loss resulting from a qualifying condition
- durable equipment adaptation and maintenance
- ECHO respite care – up to 16 hours of care per month
ECHO Home Health Care Benefit
The ECHO Home Health Care (EHHC) benefit provides medically necessary skilled services or respite care to ECHO beneficiaries who are homebound and generally require more than 28 to 35 hours per week of home health services.
- Skilled nursing services – The EHHC skilled nursing benefit provides services from a licensed nurse such as an LVN/LPN or RN. Under this benefit, the services the beneficiary needs are skilled. The number of hours the beneficiary may be eligible for is based on their level of skilled needs and the EHHC benefit cap. The suctioning of a tracheotomy tube (a breathing tube in the neck) is an example of skilled nursing care.
- EHHC respite care – The EHHC respite care benefit provides a maximum of eight hours per day up to five days per week to allow the primary caregivers time to sleep. This respite care is for the caregivers of those beneficiaries who need frequent skilled interventions three or more times in the eight-hour respite period. For example, an approved respite provider might be suctioning the mouth or giving medication or formula through a feeding tube three or more times during the respite period. The primary care giver or another adult does not have to be present when the clinician provides the ECHO respite service for the care to be covered.
Note: Only one of the respite care benefits (ECHO respite or EHHC respite) can be used in the same calendar month – they cannot be used together.