ECHO Costs and Catastrophic Cap Information
TRICARE ECHO beneficiaries have a monthly cost-share based upon the sponsor’s pay grade during the months services are used.
The sponsor/beneficiary is responsible for the appropriate amount shown in the above table plus any amount in excess of the government’s maximum coverage. The cost-share applies only once per month, not per service. If there is more than one family member receiving ECHO services, only one cost-share is required.
The monthly cost-share is paid directly to the ECHO authorized provider. Refer to your Explanation of Benefits (EOB) for the appropriate provider to pay your cost-share. The sponsor/beneficiary cost-share under ECHO is in addition to those incurred for services and items received through the TRICARE Prime, TRICARE Prime Remote for Active Duty Family Members and TRICARE Select options. The sponsor/beneficiary cost-shares under ECHO do not accrue to the catastrophic cap or deductible.
|E-1 to E-5
|E-9, W-1, W-2, O-3
|W-3, W-4, O-4
Catastrophic Cap Information
As of Jan. 1, 2019, the $36,000 ECHO benefit cap is based on a calendar year (Jan. 1–Dec. 31).
The ECHO Home Health Care (EHHC) skilled services and EHHC respite benefits are not included in these cap amounts. Coverage for the EHHC skilled services and EHHC respite care benefits are capped on a fiscal year basis.
For information on services covered under ECHO, visit our ECHO Benefits page.