What Does Tricare Vision Actually Cover?

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What Does Tricare Vision Actually Cover
Most dependents qualify for one eye exam a year with Tricare coverage. (Stock photo)

Tricare often seems like a never-ending puzzle. Military spouses struggle to figure out what is covered, which provider they can see, and what has changed since the last time they visited the doctor.

Vision coverage is a little easier to understand -- if you have Tricare Prime and no additional insurance.

What does Tricare cover for vision?

When it comes to eye coverage, Tricare vision benefits may cover exams or other services, depending on your age, your coverage and your beneficiary status.

As an active-duty family member, you get one routine eye exam each year. One well-child eye exam for those between the ages of 3 and 6 is covered every two years to screen for amblyopia (lazy eye) and strabismus (crossed eyes) at no cost. But that's pretty much it. If you need more exams or appointments, you may be able to get them after a referral from your primary care manager.

What about the FEDVIP vision coverage?

If you need more coverage, you might consider the Federal Employees Dental and Vision Insurance Program, or FEDVIP, vision coverage. It is available during open enrollment season, which runs from mid-November to mid-December, and requires an additional payment each month. You can view the available plans online and compare prices using an online tool.

The FEDVIP coverage has enrollment options that include paying for spouse (self), spouse and one child (self plus one), or family (spouse plus multiple children). Active-duty service members cannot use this program.

Costs vary depending on the plan. Monthly costs range from $6 to $15 for spouse and from $20 to $32 for spouse and multiple children. Make sure to view the additional features, as well as limitations for cost of glasses and contact lenses.

Related: Everything You Need to Know About the Tricare Dental Program

Who accepts Tricare vision insurance?

When it's time for an eye exam, some installations may see dependents at the military treatment facility optometrist. Most exchanges also have an optical shop, which can perform exams and order glasses.

You can make an appointment for an eye exam with any local network provider -- without a referral. Many military spouses report on social media that they have gotten eye exams covered at places like Walmart or Costco, but that may not always be the case.

Eileen Huck, deputy director for health care at the National Military Family Association, said the best advice to keep out-of-pocket costs low is, "To visit a network provider, which you can find by checking the directories maintained by the regional Managed Care Support Contractors."

Does Tricare cover glasses?

Now that you've successfully had your eyes checked, you may discover you need glasses. Most of the time, Tricare does not cover the cost of glasses for dependents. Rare exceptions include when glasses (or contacts) are needed to treat certain conditions, such as glaucoma or keratoconus and to retain moisture in the eyes. The full list of exceptions is available on the Tricare website.

The cost of glasses depends largely on the kind of lenses you need, based on your prescription. Some people can get away with $5 readers from Target; others will spend $300 on the glasses they need.

It's best to shop around when purchasing glasses, especially if you want to stay within budget. Some places may even offer a military discount, like the 10% Zenni Optical offers through ID.me. That discount is open to active-duty members, reservists, veterans and military spouses.

Does Tricare cover a contacts exam?

If you prefer contact lenses over glasses, you're pretty much out of luck with regular Tricare coverage. It doesn't cover routine contact lens services, the contacts themselves or the contact lens fittings -- even if done during a routine exam. If you're a contact wearer, you may want to consider using additional coverage, either through your employer, the FEDVIP program or a third party.

Will Tricare cover LASIK?

According to their website, the answer is no, LASIK is not covered by Tricare.

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