1.0 POLICY
The following are also considered
qualifying conditions for the Extended Care Health Option (ECHO):
1.1 Extraordinary physical or psychological
condition. This is defined as a complex physical or psychological
clinical condition of such severity that it results in the beneficiary
being homebound, as defined in
32
CFR 199.2. Such a condition will generally qualify the
beneficiary for the ECHO Home Health Care (EHHC) benefit, subject
to all other applicable program requirements.
1.2 Infant/toddler. TRICARE beneficiaries
under the age of three years who are diagnosed with a neuromuscular
developmental condition or other condition that is expected to precede
a diagnosis of moderate or severe mental retardation or a serious
physical disability, are considered to have an ECHO qualifying condition.
1.3 Multiple disabilities. The
cumulative effect of disabilities involving two or more separate
body systems, none of which are individually an ECHO qualifying
condition, will be used to establish a qualifying condition in lieu
of the qualifying conditions described herein and in
Sections 2.2 and
2.3.