An important aspect of healthcare is making sure your eyes are healthy. This means every aspect of eye care from eye exams to prescription lenses or contacts. Since vision coverage is typically separate from private insurance or the insurance you would get through an employer, it makes sense that many wonder if vision is included in Medicaid. As with most services, it depends largely on the state you live in.

When does Medicaid cover vision?

Vision coverage is not one of the federally mandated benefits that Medicaid must include in its coverage, so it is up to each individual state to decide whether to include vision in its Medicaid program. In most cases, vision services will be covered if they are considered medically necessary, but that is not often a term used associated with vision care.

However, Medicaid beneficiaries who are 21 or younger do receive vision and hearing screenings as part of Medicaid's Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit. This benefit also helps to cover the cost of eyeglasses for adolescents.

Beyond this, it is entirely up to the state whether any vision services (outside of an emergency of medical necessity) are covered. You can contact your state Medicaid program to see what it offers here.

Do you qualify for Medicare, too?

If you qualify for both Medicare and Medicaid, you’re what is known as dual eligible. To learn more about your Medicare options, call us toll-free at 888-992-0738. A licensed ClearMatch Medicare agent will answer your questions and help you understand your Medicare options.

Now, let's look at which states offer vision coverage through their Medicaid program.

Which states have Medicaid vision coverage?

While the best way to see exactly what your state Medicaid program covers is to contact the program directly using the link above, let's take a look at the states that offer some type of vision coverage. If you don’t see your state below, it doesn’t include vision services in its Medicaid coverage.

The following information is based on a 2018 survey.

Alabama

The state of Alabama does offer some vision services through its state Medicaid program, with a limit of one visit every three calendar years. For the most up-to-date information or to see what exactly is covered in said visit, contact the state Medicaid program.

Alaska

The Alaska Medicaid program covers vision benefits so long as there has been a prior authorization for the services. For the most up-to-date information and to see exactly what is covered in Alaska, contact the state Medicaid program.

Arizona

Vision services covered through Arizona's Medicaid program are limited to eyeglasses and contact lenses as the sole prosthetic after cataract removal. For the most up-to-date information and to see exactly what is covered in Arizona, contact the state Medicaid program.

Arkansas

Arkansas does include vision benefits as part of its Medicaid program and, as of 2018, did not report any limits on their covered vision services. For the most up-to-date information and to see exactly what is covered in Arkansas, contact the state Medicaid program.

Colorado

Colorado's Medicaid program covers vision services only after the beneficiary has gone through eye surgery. For the most up-to-date information and to see exactly what is covered in Colorado, contact the state Medicaid program.

Connecticut

In Connecticut, Medicaid covers one pair of glasses per Medicaid member every two years, unless deemed medically necessary. It also covers oversize lenses for cosmetic and physiological reasons, as well as prescription sunglasses if light sensitivity hinders your outdoor activity.

District of Columbia

D.C.'s Medicaid program covers one pair of eyeglasses for adults every 24 months, unless an exception applies. Contact lenses require prior authorization. Vision care typically has a copay of $1 per service.

Florida

For Medicaid recipients under the age of 21, Florida covers two pairs of eyeglasses every 365 days. For those over 21, the program reimburses one set of frames every two years and two lenses every 365 days. If glasses do not provide any help for visual impairment, rigid or soft contact lenses, as well as extended wear contact lenses will be reimbursed. The state also reimburses beneficiaries for the evaluating, measuring, fitting, and dispensing of prosthetic eyes.

Georgia

Georgia covers any vision services deemed medically necessary and charges a $3 copay. For the most up-to-date information and to see exactly what is covered in Georgia, contact the state Medicaid program.

Idaho

Medicaid vision coverage in Idaho is limited to post-cataract surgery lenses for an acute or chronic condition. For the most up-to-date information and to see exactly what is covered in Idaho, contact the state Medicaid program.

Indiana

One pair of eyeglasses every five years is covered under Indiana's state Medicaid program. For the most up-to-date information and to see exactly what is covered in Indiana, contact the state Medicaid program.

Kansas

Medicaid covers one pair of eyeglasses every four years in Kansas, with a copay of $2 per service day.

Maine

In Maine, one pair of eyeglasses is covered for the entirety of the time you have Medicaid. Copay ranges from $0.50 to $2 per day depending on the service amount, but can go up to $20 per month.

Massachusetts

Vision services are covered through Medicaid in Massachusetts with no reported limits or copays as of 2018. For the most up-to-date information and to see exactly what is covered in Massachusetts, contact the state Medicaid program.

Michigan

Michigan covers one pair of replacement glasses each year and a routine eye exam every two years without prior authorization. There is a $2 dispensing service.

Minnesota

As of 2018, vision services in Minnesota are covered through Medicaid with no reported limits or copays. For the most up-to-date information and to see exactly what is covered in Minnesota, contact the state Medicaid program.

Mississippi

Mississippi covers one pair of eyeglasses every five years at a cost of $3 per pair.

Missouri

One pair of eyeglasses or visual aid is covered by Medicaid in Missouri every two years.

Montana

Medicaid covers one pair of glasses every two years in Montana.

Nebraska

For $2 per pair, Nebraska's Medicaid program covers one pair of eyeglass frames every 24 months.

New Hampshire

Vision services are covered through Medicaid in New Hampshire with no reported limits or copays as of 2018. For the most up-to-date information and to see exactly what is covered in New Hampshire, contact the state Medicaid program.

New Jersey

New Jersey has reported vision coverage through Medicaid with some limits and prior authorizations required. For the most up-to-date information and to see exactly what is covered in New Jersey, contact the state Medicaid program.

New Mexico

With no reported limits or copays as of 2018, New Mexico's Medicaid program covers vision services. For the most up-to-date information and to see exactly what is covered in New Mexico, contact the state Medicaid program.

North Dakota

North Dakota covers one pair of glasses every two years, with broken glasses needing to be repaired if possible.

Ohio

One set of eyeglasses is covered every 12 or 24 months, depending on the recipient's age. There is a $2 copay on the date of service.

Oregon

Oregon does cover some vision services, with routine eye exams limited to pregnant women. For the most up-to-date information and to see exactly what is covered in Oregon, contact the state Medicaid program.

Pennsylvania

Vision care in Pennsylvania through Medicaid is limited to those diagnosed with aphakia, with a copay ranging between $0.65 and $3.80.

Rhode Island

Vision services in Rhode Island have time limits on replacements, but no reported copays as of 2018. For the most up-to-date information and to see exactly what is covered in Rhode Island, contact the state Medicaid program.

South Dakota

South Dakota covers one pair of glasses every 15 months at $2 per lens, frame, or repair.

Tennessee

Tennessee covers one pair of post-cataract surgery lenses or eyeglasses.

Texas

Texas's Medicaid program requires prior authorization for vision services. For the most up-to-date information and to see exactly what is covered in Texas, contact the state Medicaid program.

West Virginia

One pair of eyeglasses is covered for beneficiaries with a documented cataract extraction within the last 60 days in West Virginia.

Wisconsin

Wisconsin covers one pair of eyeglasses and one replacement every year, with a copay ranging from $0.50 to $3.00.

Additional resources

• ClearMatch Medicare: Find a Medicare Plan
• Medicaid.gov: Vision & Hearing Services