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It’s Time to Have Your Eyes Checked

1/29/2016

If you can’t remember the last time you had an eye exam, and it’s been longer than a year, you are overdue. Eye exams are not just about vision. Doctors can detect things like diabetes and high cholesterol from annual eye exams, not to mention eye diseases that have no known symptoms, like glaucoma.

January is Glaucoma Awareness Month. According to the American Academy of Opthamology (AAO), glaucoma is a leading cause of irreversible blindness in the United States. It has no noticeable symptoms in its early stages, and vision loss progresses at such a gradual rate that people affected by the condition are often unaware of it until their sight has already been compromised. The AAO advises that the best defense against developing glaucoma-related blindness is by having routine, comprehensive eye exams.

TRICARE covers routine eye exams for active duty service members to maintain fitness for duty.  TRICARE also covers vision screening and one routine eye examination every two years beginning at age three to age six under the Well-Child benefit although active duty family members (ADFMs) may have an annual eye exam beginning at age three. 

Prime ADFMs may receive their annual routine eye examination from any network provider without referral, authorization, or preauthorization from their Primary Care Manager (PCM). A Prime ADFM will be allowed to set up their own appointment for a routine eye examination with any network optometrist or ophthalmologist.

Standard ADFMs may self-refer to any TRICARE authorized provider regardless of whether or not they are a network provider. A Standard ADFM may set up their own appointment with either a network or non-network, TRICARE authorized, optometrist or ophthalmologist.  This includes National Guard and Reserve members and their families enrolled in TRICARE Reserve Select.

For retired service members and their families enrolled in TRICARE Prime, routine eye examinations from network providers are covered without referrals or prior authorizations once every two years.  Routine eye examinations are not covered for Standard retirees or their dependents that are not enrolled in Prime except for eye exams allowed under the well-child benefit.

Your eye exam coverage depends on who you are, your age and your TRICARE plan. For detailed information, visit the Eye Exams page on the TRICARE website.

Last Updated 10/26/2017