Is It Covered?

Search the A-Z list for a list of covered services. Your coverage and out-of-pocket costs may vary based on who you are and your health plan option.

Eye Exams

Eye exam coverage is different based on who you are your health plan option and your age. In some cases, you may need a referral and/or prior authorization. >>Learn More

Routine Eye Exams

A routine eye exam is an assessment of your vision and the health of your eyes performed by either an optometristA medical professional, but not a physician who went to medical school. They focus on regular vision services (eye exams, screenings, etc.) and prescribe eyeglasses and contact lenses. or ophthalmologistA physician who went to medical school followed by an internship and residency. Like optometrists, they provide regular vision services, but ophthalmologists also provide medical and surgical services for your eyes..

  • You’ll get a prescription for glasses or contact lenses if you need them.
  • A routine eye exam is more than the simple vision screening test conducted by your primary care doctor using a standard eye chart.

In general, TRICARE covers routine eye exams:

  • As needed for active duty service members to maintain fitness for duty
  • Annually for active duty family members
  • Every two years for all other beneficiaries enrolled in TRICARE Prime (e.g. retired service members, their families, etc.)
  • Annually for diabetic patients enrolled in TRICARE Prime

Well-Child Eye Exams

TRICARE covers well-child eye exams from an optometristA medical professional, but not a physician who went to medical school. They focus on regular vision services (eye exams, screenings, etc.) and prescribe eyeglasses and contact lenses. or ophthalmologistA physician who went to medical school followed by an internship and residency. Like optometrists, they provide regular vision services, but ophthalmologists also provide medical and surgical services for your eyes..

  • every two years
  • between the ages of three and six
  • includes screening for amblyopia (lazy eye) and strabismus (crossed eyes)

Ophthalmic Services

TRICARE covers eye exams and other specialized services to diagnose or treat a medical condition of the eye.

Disclaimer:

This A-Z list of topics is not all inclusive. TRICARE covers most inpatient and outpatient care that is medically necessary and considered proven. However, there are special rules or limits on certain types of care, while other types of care are not covered at all.

Last Updated 7/24/2014