ECHO provides financial assistance only for active-duty family members with specific qualifying mental or physical conditions. Some conditions include (please note this is not an inclusive list):
- Diagnosis of a neuromuscular developmental condition or other condition in an infant or toddler expected to precede a diagnosis of moderate or severe mental retardation or serious physical disability
- Extraordinary physical or psychological condition causing the beneficiary to be homebound
- Moderate or severe mental retardation
- Multiple disabilities (may qualify if there are two or more disabilities affecting separate body systems)
- Serious physical disability
Note: Johns Hopkins USFHP does not participate in the Autism Demonstration.
ECHO benefits, services and supplies are not available through the basic Johns Hopkins US Family Health Plan (USFHP) program. ECHO benefits provides such coverage as:
- Assistive services (e.g., those from a qualified interpreter or translator)
- Durable equipment, including adaptation and maintenance
- Expanded in-home medical services through TRICARE ECHO Home Health Care (EHHC)
- Medical and rehabilitative services
- In-home respite care services (can only be used in a month when at least one other ECHO benefit is being received):
- ECHO respite care—up to 16 hours per month (limited to the 50 United States, the District of Columbia, Puerto Rico, the U.S. Virgin Islands and Guam)
- EHHC respite care—up to eight hours per day, five days per week for those who qualify Note: The EHHC benefit cap is equivalent to what TRICARE would reimburse if the beneficiary was in a skilled nursing facility
- Training to use assistive technology devices
- Institutional care when a residential environment is required
- Special education (which can include applied behavioral analysis)
- Transportation under certain limited circumstances (includes the cost of a medical attendant when needed to safely transport the beneficiary)
All ECHO services require pre-authorization through Johns Hopkins USFHP Care Management.
ECHO Eligibility Process
For general questions, potential ECHO enrollees or family members may call the USFHP customer service telephone number at 410-424-4528 or 1-800-808-7347. USFHP also has a dedicated ECHO Care Coordinator who will assist members by answering more detailed questions regarding the eligibility and enrollment process.
To enroll in the ECHO program, members must be currently enrolled in Johns Hopkins USFHP, enrolled in the Exceptional Family Member Program (EFMP) of their branch of service and provide medical documentation that a qualifying condition exists. USFHP will grant provisional ECHO enrollment (for 90 days) while the sponsor completes the EFMP forms. Upon receipt of the application and documentation, members will receive a decision letter with their eligibility status.
Active-duty sponsors pay a cost-share that is based on their pay grade and is separate from other USFHP program cost-shares. The monthly cost-share is one fee per sponsor, not per ECHO beneficiary.
|Sponsor's Pay Grade||Monthly Cost-Share|
|E-1 to E-5||$25|
|E-9, WO/WO-1, CWO-2, O-3||$45|
|CWO-3, CWO-4, O-4||$50|
Active-duty sponsors pay a cost-share (shown in the table above) that is based on their pay grade and is separate from other USFHP program cost-shares. The monthly cost-share is one fee per sponsor, not per ECHO beneficiary. The sponsor’s cost-share does not count toward the annual catastrophic cap. Sponsors are responsible for the cost of ECHO benefits that exceed the above limits.
The government’s limit for the cost of all ECHO benefits combined, excluding the EHHC, is $36,000 per beneficiary, per fiscal year (October 1–September 30).
ECHO-allowable amounts are not subject to a deductible. The cost-share for every month beneficiaries use ECHO benefits is based on the sponsor’s pay grade.
Note: The ECHO Home Health Care (EHHC) is not subject to the $36,000 per fiscal year maximum government cost-share. For more information about ECHO, you can also visit www.tricare.mil (see benefit information) or go to http://www.hopkinsmedicine.org/usfhp/ECHO/index.html.
US Family Health Plan members should contact the Customer Service Department at 410-424-4528 or 1-800-808-7347 or USFHPCustomerService@jhhc.com for additional assistance.