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.

Since the Exceptional Family Member Program and the Educational and Developmental Intervention Services are closely related and in many cases are used by the same client base, both will be described below.

Exceptional Family Member Program

The Navy's Exceptional Family Member Program is designed to assist sailors by addressing the special needs of their exceptional family members during the assignment process. Special needs include any special medical, dental, mental health, developmental or educational requirement, wheelchair accessibility, adaptive equipment or assistive technology devices and services.

The primary goal of the EFMP is to ensure the special needs of EFM can be met at a new assignment location. EFMP enrollment information enables Navy detailers to proactively consider a family member's special need requirements during the assignment process and to pinpoint the assignment to a location with appropriate resources that address the special needs. Successful implementation requires up-to-date enrollment information and extensive coordination among the personnel, medical, and educational communities.

EFMP enrollment is mandatory per OPNAVINST 1754.2 series and required immediately upon identification of a special need. Command points of contact and Navy military treatment facility EFMP coordinators, or your FFSC EFMP Coordinator can assist service and family members with the enrollment process. DD Form 2792, Exceptional Family Member Medical and Educational Summary, is used for enrollment. DOD civilian employees and their family members are not eligible for the EFMP.

There is a reluctance to enroll because of misconceptions that EFMP enrollment may limit assignments and career advancement, or preclude family members from accompanying sponsors on overseas tours. These negative perceptions are not supported by fact. Sailors enrolled in the EFMP have always received equal consideration for accompanied assignments and for promotions.

EFMP Enrollment Process

Special needs can be identified during routine healthcare MTF or TRICARE Health Provider, self-identified Service or Family Member or identified during Suitability Screening Suitability Screening Coordinator.

Enrollment procedures are as follows:

• Refer the service and family member to the MTF EFMP Coordinator who assists with completing DD Form 2792, Exceptional Family Member Medical and Educational Summary.
• The MTF EFMP Coordinator forwards the completed enrollment form to the appropriate regional Central Screening Committee which includes NMC Portsmouth, NMC San Diego and USNH Yokosuka.
• The CSC reviews the enrollment form, recommends a category code, and forwards the form to the Navy EFMP Manager (PERS- 662F) in Millington, TN or the USMC EFMP Manager in Quantico, VA.
• PERS-662F confirms the category code and enters the enrollment data into an EFMP data base.

There are six Navy EFMP enrollment categories:

• Category I - for monitoring purposes only
• Category II - pinpoint to specific geographic locations
• Category III - no overseas assignments
• Category IV - major medical areas in CONUS
• Category V - homesteading
• Category VI - temporary enrollment update required in 6-12 months

Educational and Developmental Intervention Services 

The mission of Educational and Developmental Intervention Services is to provide early intervention services and related services assigned to the Military Medical Departments overseas to eligible military and civilian children and their families in accordance with DOD Instruction 1342.12, 17 Jun 2015 and Inter-Component Operating Procedures, 19 Dec 01 (overseas).

EDIS are provided through military medical treatment facilities but are not "medical" services, focuses on functional independence and educational development, offers the same priority as health care for active duty service members, and are proactive through ongoing child find and public awareness activities.

Services are normally provided outside the clinic setting and integrate families into the process and for early intervention, use an inter-disciplinary or trans-disciplinary approach to service delivery whenever possible.