Did you know that Tricare offers vision benefits? If you have been avoiding having your eyes examined because you thought it would cost too much or you didn’t know what Tricare covered, this article is for you. We laid out the Tricare vision benefits for you.
What are your questions regarding Tricare vision benefits?
Tricare vision benefits vary based on your status: active duty, reservist, retired, military spouse or child of active duty, reservist or retired service member. Depending on the type of Tricare plan you have also makes a difference: Tricare Standard, Tricare Prime, Tricare Remote or Tricare for Life. Once you know which Tricare program you fall under, you can easily see what your options are.
What’s covered by Tricare?
Eye Exams
For the most part, Tricare covers routine eye exams. Those on active duty can have as many eye exams as needed to make sure they are fit to continue working.
The families of active duty service members can have an eye exam conducted once a year.
All other Tricare Prime beneficiaries are covered for an eye exam every 2 years. This includes retirees and their families. If however, the patient has diabetes, they can have their eyes examined once a year.
Tricare has a benefit called Well-child Care. Eye exams for children ages 3 to 6 are covered for an eye exam every 2 years at no cost, no matter which Tricare plan they fall under. These exams can also incorporate screening for amblyopia and strabismus.
Tricare Standard and Extra along with Tricare Prime and Tricare Prime Remote beneficiaries can have their eyes examined from any Tricare authorized provider. If they are a network provider, no referral is needed.
If you choose a non-network provider and you don’t get a referral from you PCM, you can find an optometrist in their point of service system. You will face a cost share however.
Glasses and Contacts
All active duty service members, including Guard and Reserve that are activated, are permitted one pair of standard issue glasses and one pair of sunglasses as well as one pair of glasses of their choice from a military hospital or clinic. These can also be ordered through the Navy Ophthalmic Support Training Activity Command. All non-activated Guard and Reserve members will have their glasses ordered through this system. If they become activated, they will receive the same glasses as active duty service members. Retired service members can also order their glasses through this system.
Tricare does not cover glasses or contacts for dependents except for those with specific diagnoses. This includes treating infantile glaucoma, corneal or scleral lenses for treatment of keratoconus and scleral lenses are also available to those that do not have normal tearing. Intraocular lenses, as well as contacts and glasses are available for those that suffer with loss of human lens function after intraocular surgery, ocular injury or congenital absence. Pinhole glasses are covered after surgery is performed for a detached retina.
Eye Surgery and Treatment
Tricare beneficiaries are covered for most eye surgeries as well as eye treatments. It does not cover everything however.
Tricare does not cover the following eye treatments:
- refractive corneal surgery
- orthokeratology
- orthoptics vision therapy
- eye exercises
- eye therapy
- epikeratophakia or intraocular lenses for correcting astigmatism
- presbyopia
It also does not cover canaloplasty for the treatment of glaucoma or autologous serum eye drops.
Now that you know what is covered by the Tricare vision benefits, make an appointment to have your eyes examined. Make sure to schedule an appointment for your children as well.
