Presents Medicaid Vision Benefits Overview


Patients insured through Medicaid require vision coverage to ensure optimal health. Proper vision screenings can prevent serious problems from developing and guarantee that participants’ vision remains in good condition. Untreated eye conditions or infections can especially impact children’s wellbeing. Medicaid offers comprehensive treatment and health care for children and those younger than a certain age to help combat the effects of poor vision on low-income Americans and their families. States are required to educate Medicaid enrollees on the importance of preventative care and vision services, but all state policies on vision coverage differ depending on available vision care providers and funding. The team at encourages residents to pursue vision coverage and learn about Medicaid’s vision coverage and benefits for children and adults.

National Medicaid Vision Coverage Requirements

Medicaid offers complementary well-visits that include vision screenings for children and young adults younger than 21 years of age through the Children Health Insurance Program (CHIP). The team at urges families to utilize vision coverage to limit future optical damage and maintain good health. Since children and teens are susceptible to vision loss and impairment, early testing and checkups can substantially diminish the presence of eye conditions.

No federal regulations assert that Medicaid must provide vision care to adults. States determine standard vision coverage for adults and elders insured through Medicaid. Some states may offer annual eye exams, contact or eyeglass coverage and reduced copays. Additionally, medical and surgical procedures will often be covered through Medicaid. The team at recommends that enrollees familiarize themselves with their state Medicaid vision insurance policies.

Potential Medicaid Vision Benefits

Under the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit, children and teens may receive regular eye examinations, eyeglass coverage and minimal diagnostic assessments. Surgical treatment and emergency care is also provided by Medicaid vision insurance. The Centers for Medicare and Medicaid Services (CMS) has approved specialist consultations for additional care and support for children and teens. The team at suggests families research locations and offices to obtain vision care. Transportation services to and from physician appointments are also available upon request.

Other Vision Insurance Options

If participants are unable to utilize Medicaid vision services due to unavailability, other means of obtaining vision insurance are accessible. For instance, Preferred Provider Organization (PPO) plans, such as Aetna Vision, FEP BlueVision, UnitedHealthCare Vision Plan and Vision Service Plan (VSP), all offer supplemental vision insurance at minimal costs. These insurance providers discount premiums and copays if patients use in-network health care providers. While low-income petitioners may not have the option to purchase vision insurance through private insurers, having inclusive vision coverage is strongly advised. The team at recommends households compare vision insurance plans prior to purchasing extra health insurance. Beneficiaries must report any insurance changes to confirm the insurance payments are distributed appropriately.

What Is Medicaid?

Medicaid is a medical assistance program that provides coverage for various types of medical care. Eligible individuals and families can receive coverage for doctor visits, X-rays, labs, inpatient care, outpatient care and more. However, not all procedures are covered under the federal medical assistance program. To learn about which procedures are covered and to find out all about the Medicaid program, download our comprehensive guide.

Who Is Eligible to Receive Medicaid Benefits?

Medical assistance benefits are available to a wide variety of low-income individuals and families within the United States. However, all Medicaid applicants must meet the established eligibility requirements, which range from income limits to citizenship qualifications. To find out if you or your family is eligible to receive Medicaid benefits, download our comprehensive and complimentary guide.