Tricare Question

AshleighW13 · July 2013

Does Tricare cover things like speech and occupational therapy for children.

Beachy730 · July 2013

They should as long as it is prescribed by their ped. I would also look into the Exceptional Family Member Program (EFMP) to see what help and services they could provide or direct you to.

drcolleen · July 2013

Yes but, in most states the public schools are responsible for testing children for speech problems after the age of 3 so Tricare will generally not do the testing after 3 unless there are extenuating circumstances and they will only cover the extra speech therapy if there is a reason the child needs more than the school district is providing..... this is for Tricare Prime and not if the child is in Echo (autism). Hope that helps.

AshleighW13 · July 2013

drcolleen:
Yes but, in most states the public schools are responsible for testing children for speech problems after the age of 3 so Tricare will generally not do the testing after 3 unless there are extenuating circumstances and they will only cover the extra speech therapy if there is a reason the child needs more than the school district is providing..... this is for Tricare Prime and not if the child is in Echo (autism). Hope that helps.

What if he was previously diagnosed, he's been in speech therapy and occupational for a while for a sensory processing disorder, just turned three. I was wondering because my husband leaves for boot camp in a few weeks and was told that as soon as he's in boot we are eligible for Tricare. DS is also currently in the screening process for autism, if that makes any difference

Carnation77 · July 2013

https://www.tricare.mil/CoveredServices/SeeWhatsCovered/SpeechTherapy.aspx

Brandyregnier5308 · July 2013

You can contact EDIS also.

drcolleen · July 2013

AshleighW13:
drcolleen:
Yes but, in most states the public schools are responsible for testing children for speech problems after the age of 3 so Tricare will generally not do the testing after 3 unless there are extenuating circumstances and they will only cover the extra speech therapy if there is a reason the child needs more than the school district is providing..... this is for Tricare Prime and not if the child is in Echo (autism). Hope that helps.
What if he was previously diagnosed, he's been in speech therapy and occupational for a while for a sensory processing disorder, just turned three. I was wondering because my husband leaves for boot camp in a few weeks and was told that as soon as he's in boot we are eligible for Tricare. DS is also currently in the screening process for autism, if that makes any difference

Then yes, tricare should pay for it. He's going to have to be enrolled in the Exceptional Family Member Program while your DH is enrolling you guys because your son's needs will affect where your DH can be stationed. Once your son finishes his evals and assuming he is diagnosed with an Autism Spectrum DIsorder, your son will need to be enrolled in Tricare Echo which provides additional services to those dependents with ASD and this will ensure you guys get stationed places with schools and support for your son.

Hope that helps. I would certainly be familiar with the Tricare coverages via the link above, I don't know that there have been many changes since United Helathcare took this spring as I haven't heard anything, but I only have a few Tricare Echo patients on my panel and they are already in the system. Be sure they assign you a nursing case manager to help you get everything arranged when you get to your first station.

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