Eye Exams/Glasses [Update]: Tricare Standard and Medicare for non-active
duty and dependents does not cover routine eye exams and most eyeglasses.
However, care not considered routine is covered. Under the Clinical
Preventive Services of Tricare Prime a comprehensive eye exam is allowed
every two years without a co-pay for all Prime enrollees ages 3 to 64.
Medicare and Tricare will pick up their share of the bill if a patient has
a disease impacting on the eyes. Glaucoma, cataracts, torn retinas, the
variety of eye disorders related to diabetics, etc. would apply. If you
report to your doctor or ophthalmologist that you are having a problem with
your eyes and that you are not there for a routine or annual exam you/they
should be able to submit the claim. It is advisable that you first check
with the doctor/nurse to see if the exam qualifies for Medicare/Tricare
reimbursement. If they indicate it will not, call your Medicare office or
Regional Tricare contractor and ask why not. Inconsistent interpretations
by providers and payers of claims regarding the regulations do occur. If
the claim is filed and is not honored you can request a review.
If you are rated 10% disabled or more by the VA you can get one pair
of free prescription glasses a year from the VA even if the eye glasses are
not for a service connected disability. This does not apply overseas. If
you are a 100% disabled veteran who lives more than 100 miles from the
nearest VA medical care facility in the states you may be eligible for
local eye care through their Fee Basis Care program. Check with them to see
if you can apply for a fee basis card to meet your dental, eye care,
eyeglass needs up to a specified amount paid for by the VA to local
participating providers.
If you are a retiree check out your local military treatment facility
MTF if given a new prescription in the course of your visit They will fill
optical prescriptions for retirees, subject to local capacity and
funding. Retirees can now obtain eyeglasses from DoD by mail without an
examination by a military optometrist. Have your civilian optometrist
complete and sign DD Form 771 and mail to NOSTRA/NWS, PO Box 350, Yorktown
VA 23691-0250. This form can be obtained from your local RAO or downloaded
in PDF fillable format at http://web1.whs.osd.mil/icdhome/FORMS.htm.
Glasses provided will be standard brown frame and are only authorized for
the retiree, not dependents.