Simone Lawson
Tricare is a federal health insurance program for military service members and their families, as well as the Defense Health Agency. It offers vision coverage, with active-duty service members able to get eye exams as needed. Tricare covers annual routine eye exams for active-duty family members, and one well-child eye exam for those aged 3-6 is covered every two years to screen for amblyopia and strabismus at no cost. However, Tricare does not typically cover the cost of glasses or contact lenses for dependents unless they are required to treat certain conditions.
| Characteristics | Values |
|---|---|
| Who is eligible for Tricare? | Military service members and their families |
| What does Tricare cover in terms of eyesight? | Routine eye exams for active duty family members, well-child eye exams for those between 3 and 6 years old to screen for amblyopia and strabismus |
| Does Tricare cover the cost of glasses or contact lenses? | Tricare does not usually cover the cost of glasses or contact lenses, except in rare cases where they are needed to treat certain conditions such as glaucoma or keratoconus |
| Does Tricare cover LASIK? | No |
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What You'll Learn
Routine eye exams are covered for active duty family members
It is important to note that this benefit is not available to all Tricare plan members. Routine eye exams are not covered under Tricare Select, Tricare Young Adult Select, or Tricare For Life. However, those with Tricare Prime or Tricare Young Adult Prime are covered for a routine eye exam every two years. For those with USFHP, coverage depends on the specific provider.
Tricare beneficiaries who are retired service members or their families are also eligible for routine eye exams every two years. Additionally, beneficiaries with diabetes can receive medically necessary eye exams on top of their routine eye exam coverage. Well-child eye exams are also covered by Tricare and can be performed by an optometrist or ophthalmologist.
For those seeking more comprehensive vision coverage, including help with the cost of glasses, contact lenses, and laser eye surgery, the Federal Employees Dental and Vision Insurance Program (FEDVIP) may be an option. This requires separate enrollment during a Qualifying Life Event (QLE) or the next open season, which typically occurs in the fall.
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Glasses are not usually covered, except in rare cases
Glasses are generally not covered by Tricare, the federal health insurance programme for military service members and their families. This means that, in most cases, you will have to pay for glasses yourself if you are a beneficiary of Tricare. However, there are rare exceptions where glasses may be covered by Tricare.
Tricare beneficiaries who require glasses or contacts to treat specific medical conditions may have the costs covered by Tricare. For instance, if you have glaucoma or keratoconus, or if you need glasses to retain moisture in your eyes, Tricare may cover the cost of glasses or contact lenses. These exceptions are outlined on the Tricare website, and it is recommended that beneficiaries consult this resource to determine their eligibility for coverage.
It is important to note that the cost of glasses can vary significantly depending on the type of lenses prescribed. Therefore, even when Tricare does not cover the cost of glasses, beneficiaries may be able to find affordable options by shopping around and comparing prices. Some retailers may also offer military discounts, which can help make glasses more affordable for those who are not covered by Tricare.
While Tricare does not typically cover the cost of glasses, it does provide coverage for eye exams for many beneficiaries. Active-duty service members can receive eye exams as needed to maintain fitness for duty, and active-duty family members are generally eligible for one routine eye exam each year. Additionally, children between the ages of three and six can receive one well-child eye exam every two years at no cost.
For those who prefer contact lenses, it is important to note that Tricare does not typically cover routine contact lens services, fittings, or the cost of the contacts themselves. However, beneficiaries may be able to obtain additional coverage for contact lenses through their employer, the Federal Employees Dental and Vision Insurance Program (FEDVIP), or a third-party provider.
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Contact lenses are not covered by Tricare
While Tricare does offer some vision coverage, it is important to note that this does not include contact lenses. Active-duty service members can access eye exams as needed, and Tricare covers annual routine eye exams for active-duty family members, regardless of their plan. However, for those with Tricare Select, Tricare Young Adult Select, or Tricare For Life, routine eye exams are not covered.
Tricare beneficiaries who require vision correction may be wondering about their options for contact lenses. Unfortunately, Tricare does not cover the cost of contact lenses themselves. This means that if you require contact lenses for vision correction, you will need to bear the cost yourself. It is worth noting that some military hospitals and clinics may offer vision procedures that are not covered by Tricare, so there may be alternative options available for those seeking vision correction.
It is important to understand what is and isn't covered by your insurance plan, especially when it comes to specific needs like vision care. While Tricare does not cover contact lenses, there may be other options for those who need financial assistance in this area. One option to consider is enrolling in a Federal Employees Dental and Vision Insurance Program (FEDVIP) vision plan. This program offers vision coverage, and eligible individuals can enroll during a Qualifying Life Event (QLE) or during the next open season, which typically occurs in the fall.
It is worth mentioning that while Tricare does not cover the cost of contact lenses, there is some provision for eyeglasses. Tricare beneficiaries can receive deluxe or extra features for glasses, such as mirror coating, polarization, or progressive lenses. Additionally, there is coverage for the replenishment of disposable contact lenses after one initial package cost-sharing when the prescription remains the same. However, this does not negate the fact that the initial cost of contact lenses must be borne by the individual, which can be a significant expense for those who rely on them for vision correction.
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Active duty service members can get eye exams as needed
TRICARE also covers annual routine eye exams for active-duty family members. This includes family members of active-duty service members stationed overseas, who can receive eye exams from any authorized overseas optometrist or ophthalmologist. However, pre-authorization from the TRICARE overseas contractor is required for a cashless and claimless visit.
It is important to note that the coverage for active duty service members themselves differs from that of their family members. While active duty service members can receive eye exams as needed, their family members are typically covered for annual routine eye exams.
Additionally, the specific coverage for TRICARE beneficiaries can vary depending on the plan. For example, those with TRICARE Prime or TRICARE Young Adult Prime are covered for a routine eye exam every two years, while those with TRICARE Select, TRICARE Young Adult Select, or TRICARE For Life do not have routine eye exam coverage.
Furthermore, some military hospitals and clinics may offer vision procedures that are not covered by TRICARE. In such cases, active duty service members and their families may need to explore alternative coverage options, such as the Federal Employees Dental and Vision Insurance Program (FEDVIP). Enrolling in a FEDVIP vision plan typically requires taking action during a Qualifying Life Event (QLE) or during the Federal Benefits Open Season, which occurs every fall.
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Well-child eye exams for 3-6-year-olds are covered every two years
Well-child eye exams are an important part of ensuring that children have healthy vision and eye development. Through TRICARE's Well-child Care benefit, routine eye exams are covered for children aged three to six every two years. These eye exams are designed to evaluate both the child's vision and the overall health of their eyes, and they are provided by either an optometrist or an ophthalmologist.
The frequency of these exams is based on the understanding that early detection and intervention are crucial for maintaining and improving eye health. By having regular eye exams, potential issues with a child's eyesight can be identified and addressed promptly, preventing them from becoming more severe or causing further complications. This not only benefits the child's visual health but also their overall well-being and development.
During the well-child eye exams, eye care professionals will conduct a comprehensive assessment of the child's eyes. This includes screening for common childhood eye conditions such as amblyopia (lazy eye) and strabismus (crossed eyes). Amblyopia refers to reduced vision in one or both eyes due to the brain and eye not communicating effectively, while strabismus involves the misalignment of the eyes, causing them to look crossed. Early detection of these conditions is crucial, as treatment during the early developmental years can often lead to more successful outcomes.
The coverage provided by TRICARE ensures that children have access to the necessary eye care services without creating a financial burden on families. This encourages parents and caregivers to prioritize their children's eye health and seek professional care when needed. It is important for parents and guardians to be vigilant about their children's eye health and to schedule eye exams at the recommended intervals.
In addition to the routine eye exams covered every two years, TRICARE also offers coverage for other specialized services related to diagnosing or treating eye conditions. This comprehensive approach ensures that children receive the necessary care for their eye health, providing a safety net for families and contributing to the overall well-being of young children. For those with diabetes, medically necessary eye exams are also covered in addition to their routine eye exam coverage.
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Frequently asked questions
Tricare is a federal health insurance program for military service members and their families.
Active-duty service members and their families are eligible for Tricare vision coverage.
Tricare covers annual or biennial routine eye exams, depending on your plan. It may also cover the cost of glasses or contacts in rare exceptions, such as for treating certain medical conditions.
You can enroll in a FEDVIP vision plan during a Qualifying Life Event (QLE) or during the Federal Benefits Open Season, which happens every fall.
Some military hospitals and clinics may offer vision procedures that are not covered by Tricare. You may also be able to get additional coverage through your employer or a third party.
