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 (U.S.), including
members of the Reserve Component (RC) activated for a period of
more than 30 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 U.S. 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.)
1.1.4 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 of this Manual 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
1.2.4 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
n ECHO
qualifying condition.
Note: The TRICARE Overseas Program
(TOP) contractor shall advise the appropriate TRICARE Area Office
(TAO) Executive Director of all ECHO
eligibility determinations.