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Costs and Coverage Limits


You must pay part of the monthly expenses for authorized Extended Care Health Option (ECHO) benefits.  The monthly cost share is based on the sponsor's pay grade as shown in the chart below.

The monthly cost share is only one fee per sponsor, not per ECHO beneficiary.  You only pay the cost share if you use ECHO benefits during that calendar month.

Pay Grade Monthly Cost Share
E-1 to E-5 $25
E-6 $30
E-7, O-1 $35
E-8, O-2 $40
E-9, W-1, W-2, O-3 $45
W-3, W-4, O-4 $50
W-5, O-5 $65
O-6 $75
O-7 $100
O-8 $150
O-9 $200
O-10 $250

Coverage Limits
The National Defense Authorization Act for Fiscal Year 2009 called for TRICARE to increase the amount it pays for ECHO benefits.  ECHO assists eligible family members of active duty sponsors who are diagnosed with moderate or severe mental retardation, a serious physical disability, or an extraordinary physical or psychological condition.

ECHO benefits include training, rehabilitation, special education, assistive technology devices, institutional care in private nonprofit, public and State institutions and facilities and, if appropriate, transportation to and from such institutions and facilities, and respite care for the primary caregiver of the ECHO-registered beneficiary.  The TRICARE Enhanced Access to Autism Services "Demonstration", which runs until March 12, 2012, is also an ECHO benefit.

The total TRICARE cost share for all ECHO benefits combined, excluding the ECHO Home Health Care (EHHC) benefit, is $36,000 per fiscal year.  The EHHC provides comprehensive home health care services and supplies and has its own unique reimbursement limits.

If more than one family member receives ECHO benefits ...

Costs cannot be "shared" between family members.  For example, if an ECHO beneficiary in the household has used only $20,000 toward the $36,000 limit, the $16,000 difference cannot be used or credited to another ECHO beneficiary.

Last Modified:December 30, 2010