Tricare Help

Will Tricare pay for lens replacement surgery to fix cataracts?

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I am scheduled for an intraocular implant lens replacement due to cataracts in my eye. I do not see this procedure listed as a covered in the Tricare for Life web pages for eye surgery. Does TFL cover the balance due after my Medicare Part B pays their approved share?

When medically necessary and appropriate for the particular Tricare beneficiary, the costs of surgery to remove and replace the eye’s natural lens is covered by Tricare, as is one pair of spectacles following the surgery if medically necessary in the particular case.

Note that Tricare may cover the procedure only when performed by a Tricare-authorized provider. An authorized provider is one that is registered with Tricare and is approved to be paid by Tricare for covered medical services provided to Tricare beneficiaries. Tricare may not pay for any health-related services received from an unauthorized provider.

Contact your Tricare regional contractor for more information.

Will Standard cover my cataract surgery?

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I am supposed to have cataract surgery in May. My husband is my Tricare sponsor. I am 62 and not eligible for Medicare yet, but I have a supplemental policy. Will Tricare Standard pay for my surgery?

When medically necessary and appropriate for the particular Tricare beneficiary, the costs of surgery to remove and replace the eye’s natural lens is covered by Tricare, as is one pair of spectacles following the surgery if medically necessary in the particular case.

The fact that the procedure is an authorized benefit does not guarantee Tricare’s payment in a given case. That can be determined only after the service is performed and Tricare claims are filed.

Note that Tricare may cover the procedure only when performed by a Tricare-authorized provider. An authorized provider is one that is registered with Tricare and is approved to be paid by Tricare for covered medical services provided to Tricare beneficiaries. Tricare may not pay for any health-related services received from an unauthorized provider.