Eye Care Benefits

Did you know that yearly eye exams are 100% covered under TRICARE Prime for active duty service members and their families? Annual eye exams not only detect diseases of the eye like cataracts and glaucoma, but can also enable early detection of other diseases like diabetes, multiple sclerosis and high blood pressure. There are also studies that suggest children should start visiting the eye doctor as a preschooler.

My son has been in corrective lenses since the age of four; my daughter since first grade. Their
prescriptions have changed each year for the last 7 years. The information below is based on my experience with the TRICARE Insurance System for Eye Care Coverage. For the official overview on TRICARE eye benefits (Prime, Standard & Extra) visit the TRIWEST website: http://www.triwest.com/beneficiary/bolt/home.mvc/details/eye%20care:

As a TRICARE Prime beneficiary, I don‟t need a referral to visit a local Optometrist. I chose an eye care specialist who accepts TRICARE Insurance and will bill TRICARE directly so there's no out-of-pocket expense. San Pedro Eye Care on 7th Street is our local choice for Alexandra and me. I went through the TRICARE referral system and was assigned to a Pediatric Ophthalmologist in Torrance for Richard, who has more challenging visual acuity issues.
When a technician suggests their „latest and greatest‟ test or procedure, I ask if TRICARE will cover it before I answer. If TRICARE won‟t cover it, but I feel I should have the procedure, I make an appointment with my Primary Care Manager to see if the test is warranted. If so, I'll ask the PCM to create a referral through the system so the procedure will be paid for.

Unlike some health insurances, TRICARE doesn‟t cover the purchase of corrective lenses for spouses and dependents. Some eyeglass companies will offer a TRICARE or military discount so it's worth your time to shop around. But, especially with my teenage daughter, it's less about the bargain and more about the style she‟ll agree to wear. VERY COSTLY, but very worth it!

I hope you find this information helpful.

Katie H