If you’re part of a military family, you’re likely already familiar with things like enrolling in new schools after PCS, considerations you need to take when planning a vacation, and how to help your kids through those long deployment periods.
Having a special needs child in a military family often means there’s something extra to think about — including benefits and services that may help your child and family. Here’s how you can take advantage of these options.
Understanding Military Support for Families with Special Needs Children
The military offers a range of robust support systems designed to support military families raising a child with special needs. Understanding and utilizing these programs will help you meet your child's medical and educational needs, even while juggling the demands of military service.
The Role of the Exceptional Family Member Program
The Exceptional Family Member Program (EFMP) is for active-duty servicemembers with dependents who have physical, emotional, developmental, or intellectual challenges requiring specialized care. By enrolling in EFMP, you can help ensure your family’s needs are taken into consideration during the assignment process and that appropriate medical and educational services are available wherever you’re stationed.
EFMP also provides comprehensive support, including:
- Assistance with navigating medical and educational systems
- Accessing community resources
- Respite services for caregivers
Eligibility for Dependent Benefits
For adult children with special needs, securing eligibility involves completing forms such as the Secondary Dependency Application (DD Form 137) and providing supporting documents, such as medical sufficiency statements and your prior year's tax returns.
Make sure all your paperwork is meticulously prepared when you submit it, so you can access your benefits quickly and efficiently.
Financial and Medical Benefits Available
Military special needs families are also often entitled to TRICARE, Supplemental Security Income (SSI), and various other non-medical support services. Let’s take a look at how you can use these.
TRICARE Coverage for Special Needs
As the military's healthcare program, TRICARE offers extensive services, especially for children with special needs. Generally, it covers essential services such as durable medical equipment, home healthcare, mental health services, and skilled nursing facility care.
For more specialized needs, the Extended Care Health Option (ECHO) provides additional support such as medical and rehabilitative services, special education, and in-home respite care. ECHO benefits are available to dependents of active-duty servicemembers who are enrolled in the Exceptional Family Member Program (EFMP) and who meet specific eligibility criteria.
TRICARE also allows for extended coverage beyond the typical age limits for severely disabled dependents. This can help give you peace of mind that your child will have access to medical services as they transition into adulthood.
Supplemental Security Income and Medicaid Coordination
Your family may qualify for Supplemental Security Income (SSI), a federal program that provides financial assistance to individuals with limited income and resources. Receiving SSI often leads to automatic enrollment in Medicaid, which includes additional benefits that complement your TRICARE coverage. Medicaid can cover services not included in TRICARE, such as specific home- and community-based services, rehabilitative therapies, and limited respite care.
Find out how to coordinate between TRICARE and Medicaid to gain the full range of benefits your child needs.
Respite Care and Non-Medical Support Services
Military families also have access to non-medical support services aimed at improving their overall quality of life. EFMP offers respite services, or temporary relief from care duties. This includes in-home services for special needs children, which allow the primary caregiver to rest and take care of themselves. Eligibility for respite care varies by service branch and is determined through the EFMP.
Additionally, Military OneSource provides a range of resources designed to support families in navigating the complexities of military life while caring for a child with disabilities.
Housing, Education, and Relocation Assistance
Relocation, including securing housing and education, is already challenging for military families. When there’s a child with special needs to consider, these challenges become even more complex. Thankfully, there’s help for you every step of the way.
Special Education Services On and Off Base
The Department of Defense Education Activity (DoDEA) offers specialized education services for eligible students aged three to 21 who comply with the Individuals with Disabilities Education Act (IDEA).
This includes helping families receive an Individualized Education Program (IEP) for the child’s specific needs. When military families relocate, DoDEA collaborates with local school districts to facilitate the transfer and continuity of IEPs to minimize disruptions to the child's education, since challenges such as delays in transferring special education records can lead to significant gaps in services for the students who need them most. Initiatives like the Education Directory for Children With Special Needs were established to assist families in navigating these transitions.
PCS Considerations and Duty Assignments
EFMP will work with you during your PCS process to make sure that you or your servicemember are assigned to locations where your family's medical and educational needs can be met. Before a PCS move, families undergo a Family Member Relocation Clearance screening to identify any special requirements. This aims to prevent being assigned to areas lacking the services your child needs.
Despite these measures, inconsistencies in EFMP implementation across different military branches have been noted. Continued efforts are underway to standardize policies and improve support for affected families like yours.
Housing Modifications and Accessible Living
If your family member requires special housing accommodations, the EFMP will oversee modifications to your new on-base housing, which can include anything that optimizes your child’s accessibility and safety. Approval for modifications typically requires documentation of the need within the family's EFMP enrollment records.
Long-Term Financial and Legal Planning
Long-term planning for a loved one with disabilities should include serious consideration for their l financial security, legal safeguards, and continuity of care. As your child with disabilities transitions into adulthood, think about setting up plans for their well-being and continuation of benefits.
Dependent Benefits After Age 21
Typically, military dependents lose eligibility for benefits like TRICARE at age 21 (or 23 if enrolled full-time in college). But for children with disabilities, there are provisions to extend these benefits:
- Incapacitated Child Status: If a child is unmarried and incapable of self-support due to a mental or physical disability that occurred before age 21 (or before 23 if a full-time student), they may qualify as a secondary dependent. This allows continued access to benefits, including TRICARE and base privileges.
- TRICARE Young Adult (TYA): For dependents aged 21–26 who do not qualify as incapacitated, TYA offers a premium-based health plan option.
To maintain these benefits, families must provide documentation of the child’s incapacity and financial dependency. Regular reviews are required to confirm ongoing eligibility.
Special Needs Trusts and Financial Planning Tools
A Special Needs Trust (SNT) is a legal document designed to manage assets for a person with disabilities without jeopardizing their eligibility for government benefits. For military families, the 2015 Disabled Military Child Protection Act allows Survivor Benefit Plan (SBP) payments to be directed into an SNT. This grants you peace of mind that your special needs loved one will continue to be financially supported after you’re gone.
You might also consider an Achieving a Better Life Experience (ABLE) account for your child. This is a tax-advantaged savings account for individuals diagnosed with significant disabilities before age 26, which can be used in conjunction with an SNT.
Guardianship and Legal Considerations
As your child with special needs approaches adulthood, consider establishing specific legal arrangements for their continued care and protection:
- Guardianship: Appoint a trusted individual as a legal guardian to make decisions on behalf of the adult with special needs with regard to their healthcare, finances, and daily living.
- Power of Attorney (POA): A POA grants authority to an appointed person to make legal and financial decisions, which can be tailored to specific needs and established for established durations.
- Estate Planning: For those who have a child with special needs, estate planning guarantees that the family's assets provide long-term security for the child.
How to Apply for and Manage Your Benefits
Here’s how to get all the benefits you’re entitled to receive.
Enrollment in EFMP and Documentation Tips
Enrollment in EFMP is mandatory for service members with eligible family members and involves several key steps:
- Identify the need: Initiate your enrollment through self-identification, routine medical appointments, or screenings for overseas assignments.
- Complete the required forms:
- DD Form 2792: Completed by the family member's medical provider
- DD Form 2792-1: Completed by the child's school or early intervention specialist to detail their special educational requirements
- Submit your documentation: Make sure all your documents, including the ones listed above as well as IEPs or medical records as necessary, are completed and accurate before submitting them to the local EFMP coordinator.
- Maintain updated records: Update your EFMP records at least every three years, or sooner if there are changes in the family member's condition
Navigating Benefit Applications and Renewals
We briefly mentioned ECHO, which is part of the TRICARE system. ECHO provides families with financial assistance for services not covered under standard TRICARE plans, such as:
- Assistive services and devices
- Respite care
- Institutional care
- Special education and training
To take advantage of the ECHO benefits, you must first be enrolled in EFMP. You can then enroll through your regional TRICARE coordinator with prior authorization.
For SSI, the application process includes:
- Contacting the Social Security Administration (SSA) to initiate the application
- Providing documentation of your child's medical condition and your family’s income
- Undergoing a disability determination process conducted by the SSA
Please note that SSI benefits are subject to periodic reviews to assess continued eligibility.
Working with Military Support Offices
Your local military support offices can help you manage the complexities of special needs programs. These include:
- EFMP Family Support Centers: Located on most installations to provide guidance on enrollment, assignments, and access to local resources
- TRICARE regional offices: Assist with understanding your ECHO benefits, obtaining authorizations, and navigating healthcare services
- Legal assistance offices: Offer support with appeals, guardianship issues, and understanding your child’s rights under various programs
- Military OneSource: Provides 24/7 support, including confidential consultations and referrals to appropriate services
Get Help Claiming Military Benefits for Disabled Children
You don’t need to walk this road alone. You can start finding and accessing the benefits they need when caring for a child with special needs by downloading our EFMP Checklist. Then learn more about the benefits of joining Armed Forces Mutual or contact us to ensure you’re fully protecting your loved ones’ future.
This article was originally published October 17, 2018.