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TRICARE Policy Manual 6010.63-M, April 2021
Extended Care Health Option (ECHO)
Chapter 9
Section 2.1
Eligibility - General
Issue Date:  July 3, 1997
Authority:  32 CFR 199.5(b), 10 USC 1079(g)
1.1  Extended Care Health Option (ECHO) benefits are available only to the following categories of TRICARE beneficiaries enrolled in TRICARE Prime or TRICARE Select with a qualifying condition:
1.1.1  A spouse, dependent child, or unmarried person (as defined by 10 United States Code (USC) 1072(2)(I)) whose sponsor is an active duty member of one of the Uniformed Services of the United States (US), including members of the Reserve Component (RC) activated for a period of more than 30 calendar days.
1.1.2  A spouse, dependent child, or unmarried person (as defined by 10 USC 1072(2)(I)) whose sponsor is a former member of a Uniformed Service of the US when such spouse, child, or unmarried person is the victim of physical or emotional abuse. (Benefits are limited to the period that the abused dependent is in receipt of transitional compensation under 10 USC 1059.)
1.1.3  A Transitional Survivor as defined in 10 USC 1079(g)(2) and Chapter 10, Section 7.1 of this Manual.
1.1.4  A spouse, dependent child, or unmarried person who is receiving ECHO benefits at the time the sponsor dies and the sponsor was eligible at the time of death for receipt of hostile-fire pay or died as a result of a disease or injury incurred while eligible for such pay is entitled to retain the benefits under the ECHO for the greater of the period they qualify as a “Transitional Survivor” as defined by 10 USC 1079(g)(2) and Chapter 10, Section 7.1 or until the dependent reaches the age of 21.
1.1.5  A spouse, dependent child, or unmarried person (as defined by 10 USC 1072(2)(I)) who is eligible for continued TRICARE medical benefits through the Transitional Assistance Management Program (TAMP). See Chapter 10, Section 5.1.
1.2  Eligibility for ECHO benefits ceases as of 12:01 a.m. of the day following the day of the earliest occurrence of the following events:
1.2.1  The sponsor ceases to be an active duty member for any reason other than death; or
1.2.2  Eligibility based upon the abused dependent provisions of paragraph 1.1.2 expires; or
1.2.3  Eligibility based on the deceased sponsor provisions of paragraph 1.1.3 or 1.1.4 expires; or
1.2.4  Eligibility based upon a beneficiary’s participation in the TAMP program ends; or
1.2.5  The enrolling contractor determines that the beneficiary no longer has a ECHO qualifying condition.
Note:  The TRICARE Overseas Program (TOP) contractor shall advise the appropriate TRICARE Area Office (TAO) Director of all ECHO eligibility determinations.
1.3  The enrolling contractor shall notify the beneficiary in writing of the results of an eligibility determination.
1.4  A determination that a TRICARE beneficiary is not eligible for the ECHO is considered a factual determination based on a requirement of the law or regulation and as such is not appealable. Denial of ECHO services and supplies to an ineligible beneficiary is not appealable.
North Atlantic Treaty Organization (NATO) family members are not eligible for benefits through the ECHO.
September 1, 2005.
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