Health Care/Special Needs

Whether this is your first move, or you’re a seasoned professional, moving can be a challenge. A little planning and preparation can help make your move as easy as possible. Try the following Defense Department resources to help you get organized:

• PCS & Military Moves on Military OneSource.mil provides comprehensive moving resources, information and services all in one simple location
• Plan My Move, an online tool that helps break down the moving process into clear, customizable steps, with checklists to help keep you organized and on track
• EFMP & Me, an online tool to help you plan for transition and continuity of support services for your family member(s) with special needs

Make sure your transition is as smooth as possible by visiting Moving on the TRICARE website. Talk to your medical case manager before you move. They can help you find a new doctor and other resources to avoid any interruptions in coverage.

On arrival at your new duty location, you or your sponsor can contact the Beneficiary Counseling and Assistance Coordinator at the military treatment facility. They can help if you have questions or need assistance with authorizations for TRICARE Extended Care Health Option, or ECHO, services.

All TRICARE regional offices and most military treatment facilities are staffed with beneficiary counseling and assistance coordinators who educate beneficiaries and help with TRICARE-related eligibility, enrollment, referrals/authorizations and claims processing questions. If you or your family has more complex needs, contact your TRICARE case manager.

TRICARE debt collection assistance officers are assigned to regional offices and military treatment facilities worldwide. DCAOs assist with confirmed debt collection due to unpaid TRICARE claims. Please note, the debt must be in collections or listed on your credit report.

Medicaid provides health coverage for eligible individuals and families with low incomes or with special needs. The department of social services or the department of medical assistance may administer the Medicaid program in your state. Supplemental Security Income is a cash assistance program intended to assist adults and children with special needs who have limited resources. Families must reapply after moving to a new state.

Medicaid waivers are state-specific Medicaid programs that provide funding for long-term care services to be provided in the community instead of in nursing homes or hospitals. There may be waitlists for waivers, however many states have agreed to the policy of allowing active-duty military families to enroll in their state of legal residence to get on the wait list.

Learn more about Benefits for Families With Special Needs, or review the Government Assistance Programs course on MilLife Learning.

The TRICARE Extended Care Health Option provides supplemental services to:

• Family members of active-duty service personnel (this includes activated National Guard and reserve service personnel)
• Family members who are covered under the Transitional Assistance Management Program
• Children or spouses of former service members who are victims of abuse and qualify for the Transitional Compensation Program
• Family members of deceased active-duty sponsors while they are considered transitional survivors.

The qualifying family member’s disability must be entered properly in the Defense Eligibility Enrollment Reporting System to have access to TRICARE ECHO services.

For qualifying medical and/or educational special needs, TRICARE ECHO offers integrated services and supplies beyond those offered by your TRICARE program option (such as TRICARE Prime and TRICARE Select). See this TRICARE ECHO factsheet for more information, or listen to this TRICARE ECHO webinar on Military OneSource.

Military hospitals and clinics are found at military bases and posts around the world. They are also referred to as military treatment facilities. Before you move, find out your new military treatment facility and contact them for local information.

Medical case management involves a team of health care professionals who help you and your family find solutions to complex health problems. It is important to let your medical case manager know if you are moving. They can help you connect with a medical case manager at your new location. Learn more about TRICARE case management services.

If your family member has special transportation needs for the move, such as oxygen or a special bed or wheelchair, contact your TRICARE medical case manager. They can advise you on equipment and transportation.

You can also contact your current installation’s household goods/transportation office (outbound) for information on special procedures for transporting medical equipment.

Exceptional Family Member Program (EFMP)

The Exceptional Family Member Program is designed to safeguard you or your children with special needs when you are permanently reassigned to a new duty station. The Program ensures that an exceptional family member (EFM) is not moved to a location lacking necessary medical facilities or resources.

The program covers many medical, physical and emotional conditions. You should discuss any questions with your primary care manager (PCM) or call your current installation's EFMP coordinator.

Enrollment -- To enroll in the program, the special-needs family member must be listed in the Defense Enrollment Eligibility Reporting System (DEERS), be the sponsor's dependent and live in the sponsor's home.

If you answer yes to any of the following questions, you should contact the EFMP coordinator:

• Do you have a child with a disability?
• Do you have a child in special education for more than 20 percent of school time or receiving medically related services?
• Do you have a spouse or child receiving treatment for cancer, lupus, heart ailments, diabetes, asthma, leukemia, mental health, or other long-term illnesses?
• Have you recently considered a hardship discharge because of special family medical or educational needs?
• Have you recently submitted a NAVPERS 1306/7 requesting special assignment consideration because of special needs?
• Has your family recently been returned from overseas because medical or special educational services were unavailable?
• Have you had to take an unaccompanied tour because a family member failed overseas/isolated duty screening?
• Are you enrolled in the CHAMPUS program for the handicapped?
• Do you have a child receiving medical Social Security supplemental income (SSI) benefits?
• Are you a geographical bachelor because of a family member s special medical or educational needs?

EFM Program Information

A sponsor or family member can inquire about the program or a school official or PCM may make a recommendation. The family member in need then will undergo a series of examinations and evaluation.

Family members, after being evaluated, will be placed in categories based on their needs. This helps alert the sponsor's branch of service when a permanent change of duty station is pending. All services will try to assign sponsors to areas where the needs of the EFM can be met. This does not mean, however, that the service member will not be sent to areas where care is unavailable. The sponsor can still be assigned to unaccompanied tour, sea duty, deployments, or other rotation.

One of the first questions that arise in discussing the Exceptional Family Member Program (EFMP) is how will it affect the sponsor's career. In all the service branches, enrollment will not disrupt the sponsor's chances for promotion, their ability to attend schools or other temporary duty assignments.

The program will determine locations to which an exceptional family member (EFM) can move when the sponsor is reassigned. The service branch usually will try to keep the family together by finding a location with the services the EFM will require. Remember, though, that the program does not make service members non-deployable nor does it exempt them from unaccompanied tours, sea duty, field problems, or other military-related missions. It only ensures that the EFM will not be sent to an area that lacks the needed facilities.

Helping Your Family

Often a family with a special needs child or a spouse needing special care fears that the program will somehow make life more difficult. The truth is that there are a wealth of programs that may be beneficial to both the family member and the sponsor.

There are five or six categories that the EFM can be placed in after they are evaluated. This alerts your installation to the assistance you or your family member will. For some disabled children or spouses, special housing may be provided with wheelchair access or other features.

Installations often work with civilian agencies to provide specialized care or support. There are programs available through your installation s Family Service/ Community Service Center that provide reduced childcare, financial assistance and counseling about medical costs, support groups for persons caring for special-needs children and more.

The fact that a family may not be able to move to a secluded location should not deter anyone from seeking assistance that is readily available. Also, EFMP enrollment is mandatory for all sponsors, in all service branches, with a special-needs dependent living in their home.