TRICARE Prime offers health care coverage for a wide range of examinations and medical procedures for active duty personnel, their dependents, as well as retirees and their dependents. Such benefits include routine vaccinations for children and adults, women’s check-ups, antenatal and postnatal treatments, as well as preventative medical treatments. But does TRICARE Prime cover the cost of contact lens examinations?
TRICARE Prime Vision Exams Vary
TRICARE states that the vision benefit varies depending on whether you are active duty or retired. Active duty personnel and their dependent family members are entitled to a routine vision exam each year at no cost. Retirees and their dependent family members receive similar coverage for a routine vision examination.
However, retirees and their family members are only entitled to one free routine eye exam every two years, starting from the last eye exam they received while they were on active duty.
TRICARE Prime Contact Lens Exams
Active duty personnel should receive their routine vision examination and contact lens exam at the Military Treatment Facility (MTF) which will be free of charge. If they wish to see a civilian provider, they will need to obtain prior approval for a contact lens examination away from the MTF, otherwise, they will be required to pay the full cost of the contact lens exam. Retirees who are TRICARE Prime beneficiaries are required to pay a cost-share for a contact lens examination.
According to TRICARE, “Benefits are limited to only one set of implantable lenses required to restore vision. A set may include a combination of both implantable lenses and eyeglasses when the combination is necessary to restore vision. If there is a prescription change related to the qualifying eye condition, a new set may be cost-shared.”
TRICARE Prime vision examinations vary according to your status. Active duty personnel and their dependent family members are entitled to a free vision examination each year, whereas retirees receive a free vision examination every two years. Active duty personnel are provided with a free contact lens exam, as well as a free set of contact lenses at their vision appointment. If their prescription changes and they require a new set of contact lenses or glasses to restore vision, this may be cost-shared. Retirees are required to pay a cost-share for a contact lens examination.
TRIWEST Healthcare Alliance, TRICARE Vision Coverage