Eligibility and Qualifying Conditions
In order to register in the Extended Care Health Option (ECHO), beneficiaries must meet the eligibility requirements below and have an ECHO-qualifying condition.
Eligibility
ECHO benefits are available for the following TRICARE-eligible beneficiaries:
- Active duty family members (ADFMs)
- Family members of National Guard and Reserve members who have been activated for more than 30 consecutive days
- Family members enrolled in the Transitional Assistance Management Program (TAMP)
- A spouse, dependent child or unmarried person who is the victim of physical or emotional abuse
- Survivors of a deceased service member:
- The spouse, dependent child or unmarried person who is receiving ECHO benefits at the time
the sponsor dies. The sponsor must have been eligible for hostile-fire pay at the time of death.
- A transitional survivor whose active duty sponsor died on or after October 7, 2001
Duration of ECHO benefits is limited for survivors. Contact an ECHO coordinator for additional information.
Note: North Atlantic Treaty Organization (NATO) family members, and TRICARE Reserve Select (TRS) and retirees and their family members are not eligible for ECHO.
Qualifying Conditions
Beneficiaries must meet one of the eligibility criteria above and also have a qualifying condition. Qualifying conditions may include, but are not limited to:
- Moderate or severe mental intellectual disability
- A serious physical disability (for example, cerebral palsy, spina bifida, multiple sclerosis, significant vision impairment or hearing loss) or any other serious disability that creates a significant impairment in a major life activity
- Under 3-years old with a developmental delay when psychometric tests are two deviations below the mean in adaptive, cognitive, or language
- Diagnosis of a neuromuscular developmental condition or other condition in an infant or toddler (under age 3) that is expected to precede a diagnosis of moderate or severe intellectual disability or a serious physical diability
- Cerebral palsy
- Spina bifida
- Multiple sclerosis
- Autism spectrum disorder
- Physiological disorder or anatomical loss which has lasted, or is expected to last, 12 consecutive months that affects a major life activity (such as breathing, cognition, hearing, seeing, bathing, dressing, eating, grooming, speaking, stair use, toilet use, transferring, and walking)
- Hearing or vision loss that meets criteria
- An extraordinary physical or psychological condition of such complexity that the beneficiary is homebound (for example, a beneficiary at home with a tracheotomy and/or on ventilator support)
- Two or more disabilities affecting separate body systems such that one disability alone is not an ECHO qualifying condition (for example, a beneficiary with a combination of a mild hearing and vision impairment)
