What an ophthalmologist does
Ophthalmologists are medical doctors and surgeons for the eye. They treat cataracts, glaucoma, macular degeneration, diabetic eye disease, and eye injuries, and perform eye surgery.
What CHAMPVA covers for ophthalmology
Medical and surgical eye care is covered outpatient or inpatient care under CHAMPVA's standard rules, and no referral is needed. Regulation specifically allows lenses that replace lens function lost to surgery or injury, one set per qualifying condition, which is how post-cataract glasses are covered. Routine vision checks and ordinary eyeglasses remain excluded. Hospital-based eye surgery at a Medicare-participating facility falls under the rule that the hospital must accept CHAMPVA.
Find ophthalmologists who can bill CHAMPVA, by state
Pick your state. The search opens with the Ophthalmology filter already selected and shows real practice locations from the federal NPPES registry, with street addresses and local phone numbers. Then call with the 20-second script to confirm CHAMPVA.
Common questions
Does CHAMPVA cover cataract surgery?
Yes. Cataract surgery is medical eye care and is covered, and regulation allows one set of lenses to replace lens function after the surgery.
Does CHAMPVA cover glaucoma and macular degeneration treatment?
Yes. Diagnosis and treatment of eye disease is covered medical care with the standard deductible and 25 percent cost share.
Do I need a referral to see an ophthalmologist with CHAMPVA?
No. CHAMPVA does not require referrals for specialists.
Related guides
Sources
- CHAMPVA care: what is covered and what it costs (VA.gov)
- Getting care through CHAMPVA: network, referrals, and preauthorization (VA.gov)
- CHAMPVA provider fact sheet, VA IB-10-1587 (PDF)
- 38 CFR 17.272, CHAMPVA benefit limitations and exclusions (eCFR)
General information, not medical or insurance advice. Coverage rules are set by the VA and federal regulation and can change; confirm with CHAMPVA at 800-733-8387 before treatment.