1. TRICARE-Healthcare for Military Families Essential Information for Parent Centers
Hi! You are about to view a short e-learning module about the first of three important benefit programs for military families who have children with disabilities. The three programs are TRICARE, TRICARE’s Extended Care Health Option, or ECHO, and Applied Behavior Analysis or ABA therapy, also through TRICARE. This module is an overview of the TRICARE program.

2. Objectives
Find out why it’s important to know about TRICARE programs for military-connected children with disabilities
Learn the basics about TRICARE
Understand TRICARE benefits in relation to a child’s educational services
Get resources to share with families
By the end of this e-learning module, you’ll have found out why it’s important to know about this military healthcare program and learned how TRICARE benefits may affect or support special education services. We’ve included a slide with links to our full articles and parent handouts on each program.
At the end, you have a chance to take a short quiz. The quiz is designed to help you remember what you learned from the slides, and let you know if you missed something or misunderstood something. You can take the quiz and view the PowerPoint as many times as you wish. Receive a certificate of completion by adding your name and to our form on the survey.

3. What is TRICARE? Department of Defense healthcare program for:
Active-duty and retired service members of the military (and the Commissioned Corps of the US Public Health Service and National Oceanic and Atmospheric Association) and their families
National Guard and Reserve service members and their families when the service member is activated (called up for federal duty)
TRICARE is an entitlement program established by Congress-it’s not insurance
TRICARE is the military healthcare program. It covers active duty and retired service members and their families. It also covers National Guard and Reserve service members and families when they are called up for federal duty.
It provides healthcare for members and families of the Commissioned Corps of the US Public Health Service and the National Oceanic and Atmospheric Association, even though they are not military.
TRICARE isn’t health insurance—it looks like it, it acts like it—but it’s an entitlement program established by Congress, and all changes to the program need to be changed by Congress
HIGHLY IMPORTANT: if a military family is also trying to access Medicaid benefits, Medicaid is the secondary payor. This means that if a benefit is covered by TRICARE as well as Medicaid, TRICARE pays first, and Medicaid may cover the remainder of costs.

4. Why it’s important to know if a family has TRICARE
Can offer some services and supports similar to Home and Community Based Services Waivers (through ECHO program)
Military families are not always aware of services for their child, especially with a new diagnosis
Families whose service member is leaving the military benefit from information on civilian programs
You may regularly provide information to families about Medicaid waivers, vocational rehabilitation, programs for children with developmental disabilities, and the like. A military family may not stay in your location long enough to access or benefit from some of these programs, and may not be aware of their own military benefits. If you know the basics of what TRICARE offers, you can give that information to military families so they can begin to use their entitled benefits.
Another important reason to know about these programs is that some of the benefits offered are the same as services given through a child’s IEP, such as Occupational and Physical therapy, speech pathology services, or ABA therapy. It’s easy for parents (and schools!) to get confused as to which entity pays for what services and when. When you understand how TRICARE interacts with school services, you can help military families clarify issues that may come up with their child’s school.
Families whose service member is leaving the military can benefit from your knowledge of services previously provided through TRICARE that they will now need to get through other government or community resources.

5. Why it’s helpful to know if a family is National Guard or Reserve
Switching to TRICARE can ease a family’s financial situation, which is often impacted when a service member is deployed
Option to sign up for TRICARE when the service member is called to federal duty
Families may be unaware of TRICARE benefits such as the Extended Benefit Health Option (ECHO) or ABA therapy.
When National Guard or Reserve members are called up for federal duty, such as a deployment to a war zone, their family members have the option to go onto TRICARE rather than stay on their civilian health insurance. TRICARE is frequently less expensive even then employer-provided insurance, which can be important because these families often experience a drop in income when their service member is activated. Many of these families have no idea about what TRICARE can offer their child with a disability. Finally, because when a person receives TRICARE benefits Medicaid is the secondary payer, if a child becomes TRICARE-eligible Medicaid may require the family to use TRICARE benefits before Medicaid will pay. Your knowledge of TRICARE’s programs can help direct families to appropriate TRICARE contacts for more help and information.

6. What about Veteran’s families?
Tricare is available to families and service members if the service member retires, as opposed to leaving the service prior to retirement
Benefits for retirees’ adult children incapable of self- support may be maintained
Service members often retire as their children are about to age out of TRICARE coverage. If you are helping such a family, you can direct them to the resources listed on this page, and again at the end of the module.

7. TRICARE programs for children with disabilities
Case management for individuals who have significant chronic or high-risk health issues
Hospice
Mental health and Substance Abuse Disorder services
Extended Care Health Option (ECHO)
Autism Demonstration: Applied Behavioral Analysis (ABA) Therapy
In this module we’re going to look at the basics of the TRICARE healthcare program.
Additional modules go into detail on the topics of Mental Health, Substance Abuse Disorder, the Extended Care Health Option, and the Autism Demonstration. These are all TRICARE programs which can benefit military families who have a child with a disability.
TRICARE offers medical case management for children with high-risk or complex health needs. This is separate from the non-medical case management offered through the Exceptional Family Member Program.
You may be helping a family whose child needs hospice care. It can be helpful to your interactions with the family if you know that TRICARE will not allow an individual, including a child, to receive hospice care and curative care simultaneously. This means that the palliative and supportive care of hospice aren’t available if a family is also trying to get a cure for their child’s condition-for example, if their child has cancer. This is because TRICARE is based on Medicare’s hospice standards, which are designed for adults with life-threatening conditions. This standard is not supported by current pediatric medical standards, but changes to TRICARE require legislative action.

8. TRICARE coverage for children
“Children means biological, adopted, and/or stepchildren who are living in the home, or for whom the service member has a legal obligation (such as a child living with a former spouse or living with another relative)”
Coverage until age 21 or age 23 if in college
OR can continue under parent’s TRICARE if the service member applies to have a child declared an “incapacitated adult”
Unlike a civilian family, if an active-duty or retired service member needs health coverage and other TRICARE benefits for an adult child, there is a process by which some children may qualify for indefinite coverage under the service member’s family plan.
The service member may apply to have the adult child declared an “incapacitated adult”. The term is a bit unfortunate, but allows the adult child to continue receiving health coverage and other military benefits. A link to the Branch article on how a family can do this is on the Resource slide at the end of this module.
It may be important for such families to understand the interaction between TRICARE and Medicaid.

9. TRICARE and school services
Can TRICARE be used to evaluate a child for special education services or to obtain a 504 plan?
No, but—
TRICARE does cover psychological testing and assessment to diagnose a condition and develop a treatment plan
Results from TRICARE-covered psychological tests or assessments may be used as a part of the school’s evaluation process
It’s important for military families to know that even though their child may have had an assessment or diagnostic test through TRICARE, they cannot use the results of that test as a school evaluation to get special education services.
You can get more information about the interaction between TRICARE and special education services in the modules on ECHO and Autism Services, and the one on Mental Health and Substance Abuse Disorder Services.

10. Resources Download as Word docx Parent Handout
TRICARE: Healthcare for Military Families
Download Word docx.
Secondary Dependency (process to declare an adult child an “incapacitated adult”)
Download Word docx
Resources for parents, professionals and individuals on disability and reaching the age of majority (from the Center for Parent Information and Resources)
Medicaid: Referring Military Families to Supports and Services
Download as Word docx
Parent Handout p
Extended Care Health Option (ECHO)
TRICARE ABA handout

11. ………..and finally……..
Want to reinforce your learning? Take this short quiz!

12. This document was produced under US Department of Education, Office of Special Education Programs No. H328R The views expressed herein do not necessarily represent the positions or policies of the Department of Education. No official endorsement by the US Department of Education of any product, commodity, service or enterprise mentioned in this publication is intended or should be inferred. This product is public domain. Authorization to reproduce it in whole or in part is granted. While permission to reprint this publication is not necessary, the citation should be: The Branch, MPTAC (retrieval date). (Title), Tacoma, WA. The Branch Staff.