This is the Family Member Medical Summary that is used for enrollment in the Exceptional Family Member Program. This form must be completed by a qualified medical provider and submitted to your local installation EFMP office or HQMC EFMP via email hqmc.efmp@usmc.mil. It is the sponsor's responsibility to update their enrollment every 3 years or as the medical needs of the exceptional family member's conditions change. If your family member no longer requires special medical services, have your physician complete the form for medical status updates.

Yes, the Marine Corps believes that families should not bear the cost of form completion to comply with a DOD mandated program. Some TRICARE authorized providers are charging families for completion of the DD 2792, referencing the TRICARE policy manual which expressly excludes reimbursement for completion of the form. Absent reimbursement or regulation, authorized provider charges to families are inconsistent and, in some cases, cost prohibitive for family members.

Marines will be reimbursed for pages 4-7 at the actual cost charged to the family or $60, whichever is less. If page 8 (Asthma Addendum), 9 and 10 (Mental Health Addendum), or 11 (Autism Spectrum Disorders and Significant Developmental Delays) are applicable, reimbursement will be actual cost charged to the family or $15 per page, whichever is less. Reimbursement will never exceed $200/package.

If a TRICARE authorized provider charges more than the Marine Corps will reimburse, families may ask providers to reconsider the cost charged to the family to align with USMC EFMP reimbursement amounts. If providers are unwilling to do this, families are responsible for any costs beyond the maximum reimbursement amounts. Families should contact their EFMP office for any questions about reimbursement.

An official family member with an exceptional medical or special education need, registered in DEERS, who resides with the active duty service member sponsor. This can include a spouse, child or dependent adult. It is mandatory (by MCO 1754.4C) that the Marine enroll a family member who has special medical or educational needs. Contact your EFMP office if you are unsure if you should enroll a family member.

REF: MCO 1754.4C
It is DoD policy that family members who meet any of the following criteria will be enrolled in the EFMP:

• Potentially life threatening conditions and/or chronic medical/physical conditions requiring follow up support more than once a year and/or specialty/sub-specialty care.
• Current and chronic (duration of six months or longer) diagnosed mental health condition, inpatient, or intensive outpatient mental health service within the last two years. Intensive outpatient is defined as monthly, or more frequent, mental health services.
• A diagnosis of asthma or other respiratory-related diagnosis with scheduled use of inhaled anti-inflammatory agents or bronchodilators, a history of acute asthma exacerbations, or history of hospitalizations, as captured on the DD Form 2792.
• A mental health diagnosis (including Attention Deficit Disorder) that requires prescribed psychotropic medication(s) and/or treatment by a mental health provider (e.g., psychiatrist, psychologist, licensed clinical social worker, etc.).
• Special Education Eligibility Under the Individuals with Disabilities Education Act (IDEA):
  • An infant or toddler with a developmental disability (birth through two years inclusive) in conformity with an Individualized Family Service Plan (IFSP) specifying early intervention services.
  • A school-age child (ages 3 through 21 years inclusive) is entitled when a school determines a child's educational performance is adversely affected by one or more disabling conditions. Eligibility for special education services is documented by a current Individual Education Program (IEP).

By submitting a DD Form 2792. Also, submit a DD Form 2792-1 for any children receiving special education, to include children ages 0-3 with an Individualized Family Service Plan (IFSP). If you have any questions about the enrollment process, please contact your local EFMP office.

Ensuring the confidentiality of all Personally Identifiable Information and Protected Health Information is paramount. All enrollment forms and accompanying documents and information are maintained in a password controlled database with predefined need-to-know criteria for all EFMP staff members. Information contained in the database will not be shared without specific written permission from the sponsor and/or adult family member. Local EFMP Managers provide limited information to the Unit Commander, or his/her designee to ensure commands are aware of those Marines who need to complete an update to maintain compliance. The information shared with the command is limited to the name, date of enrollment, and date of next tri-annual update. The specific medical diagnosis and treatment and/or special education needs of the family member will not be shared with the Command, unless the sponsor and/or adult family member provides written permission to do so. The EFMP Case Management System will not become an element of the Manpower Management System, individual record books, or the parent command records of the sponsor, nor be referenced in performance appraisals such as Fitness Reports.