What is the Exceptional Family Member Program?
The EFMP or special needs program is for active duty family members and other eligible beneficiaries with special medical and/or educational needs and provides support to those families. It helps ensure military families are located in an area where family members can receive the services they need.
Enroll in EFMP
To enroll in EFMP, the active duty family member and his or her health care provider must complete the required forms, available on the Military OneSource website. The beneficiary submits the completed forms to the appropriate military hospital or clinic's EFMP special needs program office. Beneficiaries may contact a special needs advisor or case coordinator at the military hospital or clinic, or contact their service branch's EFMP representative.
EFMP Enrollment Exceptions
The EFMP/special needs program enrollment requirement may be waived in the following circumstances:
- This program does not exist for a particular branch of service such as the National Oceanic and Atmospheric Administration (NOAA) or the Public Health Service (PHS).
- The beneficiary resides with a custodial parent who is not the sponsor.
- The beneficiary is a survivor of a deceased sponsor.
- The beneficiary's sponsor is a mobilized National Guard or Reserve member.
ECHO Registration
HNFS reviews and processes ECHO registration requests for the TRICARE West Region. We require:
- Proof of an ECHO qualifying diagnosis.
- Proof of the active duty family member’s enrollment into EFMP.
There is not an ECHO-specific application packet. Rather, to register for ECHO, beneficiaries must submit one of the following to HNFS for evaluation and review:
- a printed out summary of the EFMP registration (can be obtained from the EFMP office) or
- a copy of the DD2792 packet with page 3 signed by an EFMP coordinator or
- a Q-code letter confirmation EFMP registration that lists beneficiary name and supplemental documentation confirming the diagnosis.
Beneficiaries can submit supplemental documents (such as evaluations by TRICARE-authorized providers) as proof of an ECHO qualifying condition.
Submit the required documents via fax to 1-888-965-8438. Please use a fax cover sheet that includes the sponsor's Social Security number or DoD Benefits Number so we can assign the documents to the correct beneficiary.
Provisional Enrollment for the Autism Care Demonstration
Active duty family members who are enrolled into the Autism Care Demonstration (ACD) are automatically given a 90-day provisional ECHO registration period that begins at the start of their initial assessment.
Although the beneficiary will receive an ECHO registration welcome letter and have the ability to access ECHO and applied behavior analysis (ABA) benefits during the provisional ECHO registration period, he or she must complete the ECHO registration process within the 90 days. Beneficiaries who have not completed ECHO registration by the end of the 90th day of the provisional enrollment will be discontinued from ABA services. HNFS will send a confirmation to the beneficiary when the ECHO registration process is complete.
Beneficiaries who have additional questions about the Autism Care Demonstration can contact HNFS’ ABA Customer Service team by phone at 1-844-866-WEST (9378), option 5 (during business hours) or by email at CS_ABA@healthnet.com.
ECHO Program Review Process
HNFS’ ECHO team will review the required documents received via fax to determine eligibility into the program. If we require additional information to complete the review, we will notify the beneficiary. We are unable to complete the review process with incomplete documents.
HNFS will register beneficiaries approved as eligible into ECHO and send a welcome letter confirming registration. The beneficiary will also receive a letter from DEERS confirming registration.
Maintaining ECHO Enrollment
- Beneficiaries should monitor their records to ensure that changes to plan type eligibility do not impact their status in the ECHO program.
- Beneficiaries accepted into ECHO who move across regions (for example, West Region to East Region) will remain registered and do not need to re-register in the new region.
- ECHO benefits end when the beneficiary no longer has an ECHO qualifying condition or the sponsor no longer meets eligibility requirements (such as retirement). Beneficiaries who anticipate changes to their ECHO eligibility after registration should contact HNFS to discuss the transition out of the program.
Beneficiaries can contact HNFS should they require additional support after registration into ECHO.
