News | Oct. 14, 2021

Keeping Your Eyes Healthy With TRICARE

By TRICARE Communications

Do you think you need glasses or contact lenses? If so, you aren’t alone. About 11 million Americans over age 12 need some form of vision correction, according to the Centers for Disease Control and Prevention. Of course, the best way to find out if you need vision correction is by seeing your eye doctor. And as a TRICARE beneficiary, you may be eligible for vision coverage to help you do that. Here’s a closer look at your vision benefits and how you may qualify.
 
Eye exam coverage
As stated by the Mayo Clinic, “An eye exam helps detect eye problems at their earliest stage—when they’re most treatable.” TRICARE covers eye exams and other specialized services to diagnose or treat eye conditions. Your coverage is based on who you are, your health plan, and your age. For active duty service members (ADSMs), TRICARE covers eye exams on an as needed basis to help you maintain fitness for duty. If you aren’t an ADSM, the number of TRICARE covered eye exams you can receive are limited to:  
  • Once per year for active duty family members
  • Every two years for children ages 3-6 as part of the well-child care benefit
  • Every two years for retirees and eligible family members enrolled in TRICARE Prime
 
Are you a diabetic patient enrolled in TRICARE Prime? If so, you’re eligible for an annual eye exam, which is in addition to your routine eye exam coverage. TRICARE doesn’t cover eye exams for retirees and their family members who aren’t enrolled in a TRICARE Prime plan, including TRICARE Young Adult Prime, unless the eye exam is part of a well-child exam. Talk to your TRICARE contractor if you have any questions about coverage and eligibility. Keep in mind, you may need a referral and pre-authorization before you get an eye exam.
 
“When you need your eyes checked, knowing where you can go to receive an exam is important,” said Elan Green, chief of TRICARE Health Plan’s Member Benefits and Reimbursement Section. “Be sure to check the rules of your plan. You may have the option to visit a military hospital or clinic, or see any TRICARE-authorized optometrist or ophthalmologist.”
 
Visit TRICARE Eye Exams and click on your beneficiary category to learn more about your options for seeing an eye doctor.  
 
Glasses or contact lenses coverage
After your eye exam, your eye doctor may provide you with a prescription for glasses or contact lenses if you need them. TRICARE only covers glasses or contact lenses to treat certain conditions, like infantile glaucoma, for family members. However, if you’re an ADSM, a member of the National Guard or Reserve, or a retiree, TRICARE will cover the cost of glasses or sunglasses needed for vision correction. TRICARE doesn’t cover adjustments, cleaning, and repairs for glasses. Visit TRICARE Covered Services to learn how you can order your glasses with TRICARE if you’re eligible.
 
Not eligible for glasses or contacts with TRICARE? You may qualify for the Federal Employees Dental and Vision Insurance Program (FEDVIP). FEDVIP vision plans may include coverage for routine eye exams, eyeglasses, contact lenses, and more. Coverage and costs vary by plan. You must be enrolled in a TRICARE health plan to get FEDVIP vision coverage. Go to the BENEFEDS website to learn more about FEDVIP coverage and eligibility requirements. Keep in mind, you can only enroll in FEDVIP during the Federal Benefits Open Season or if you experience a FEDVIP qualifying life event. This year’s open season will run from Nov. 8 to Dec. 13. This is the same dates as the TRICARE Open Season.
 
Taking command of your health includes taking care of your eyes. Be sure to visit the TRICARE Vision page to learn more about your vision benefits and explore options for you and your family. 
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