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TRICARE Policy Manual 6010.60-M, April 1, 2015
Extended Care Health Option (ECHO)
Chapter 9
Section 2.4
Eligibility - Qualifying Condition: Other
Issue Date:  July 3, 1997
Authority:  32 CFR 199.2, 32 CFR 199.5(b)(2)(iii), (b)(2)(iv), (b)(2)(v), and 10 USC 1079(d)(3)
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.
September 1, 2005.
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