Medicaid, Medicare, and Vision Care

Do You Need Vision Insurance?

It is important to have good medical insurance to maintain your health. The decision to purchase vision insurance can be complicated since many aspects of eye care are not covered by regular medical insurance.

Generally speaking, eye care that is related to an overall medical condition falls under your healthcare policy. An example of this would be where a doctor deems an ocular exam necessary for a diabetic with high blood. In such circumstances, medical insurance may cover the cost of an appointment with an optometrist under the framework of general health.

Some medical insurance plans offer supplemental plans to cover eye care. Others combine vision and dental care coverage as a package. Depending on your individual needs, you will need to determine if it is a worthy investment. For those who require extensive vision care, the costs can add up. Vision insurance may be the way to go.

The Beginner's Guide To Vision Insurance

There are many different kinds of vision insurance on the market, and they all have their own benefits. Plans may offer the following benefits:

Coverage for contact lenses or prescription glasses, either free of cost or at a reduced price.
Coverage for annual exams
Copayments and deductibles saving you money for the overall cost
Top tier plans often feature partial coverage for surgical ocular procedures

How Much Does Vision Insurance Cost?

Prices vary depending on how extensive the plan. Simple plans can be as low as $10 monthly. Higher tier plans can cost as much as $30 monthly but may offer top-tier benefits such as discounts on corrective surgery such as LASIK.

Things To Consider

When shopping around for a vision insurance plan consider the following:

your personal medical profile and individual needs
monthly cost
cost of copayments or deductibles
company rating
types of benefits, including the cost of prescription lenses and frequency of benefits
Identifying visual-motor and neurological deficits and implementing corrective measures including a rehabilitation plan of Vision Therapy

Are Medicaid and Medicare Viable Options For Vision Care?

Medicaid and Medicare are federal and state programs providing assistance and insurance for seniors and people with a low income. While neither program offers extensive vision care, speak with state providers to see if you are eligible and to determine if they provide viable options for you.

Medicaid

Medicaid is run jointly as a federal-state program providing medical assistance to anyone with a low income regardless of age. The benefits vary by state, and it is either free or available with partial payments. Benefits include the following:

As part of The Early, Periodic, Screening, and Diagnostic Program (EPSDP), states provide glasses and eye exams for children and young adults. The amount of coverage depends on what is deemed medically necessary. Benefits vary by state.
Does not cover surgeries for refractive error

Medicare

Medicare is a federal program providing medical insurance for all seniors regardless of income, including younger disabled people. The cost is low, either in the form of low monthly premiums for non-hospital care and deductibles. Medicare does NOT provide coverage for routine eye exams, and in most cases, it will not cover contact lenses or glasses. However, it does offer the following benefits:

An annual exam for diabetics and those at high risk for glaucoma
Coverage for certain procedures, tests, and surgeries for ocular diseases and conditions
Eye exams to check for serious conditions
Medicare Part B offers coverage for glasses following cataract surgery if you had an intraocular lens attached post-surgery

Do You Need Vision Insurance?

Do you have poor vision and require frequent examinations that aren't covered by medical insurance?
Will you be purchasing prescription glasses or contact lenses during the year?
Are you considering corrective surgery?

Generally speaking, Medicaid and Medicare provide limited benefits for vision. For those with a limited income, contact a state Medicaid or Medicare provider to find out if they offer viable options that match your needs.

Common Questions

What is the difference between medical and vision insurance?

Vision insurance typically is used for eye exams, frames, lenses and contacts whereas medical insurance is generally used only for exams that have a medical nature such as dry eye or another medical diagnosis.

Does medicaid cover vision therapy?

Eye conditions such as amblyopia, strabismus, convergence insufficiency and binocular vision dysfunction are treated in vision therapy. These conditions are classified as medical issues rather than refractive errors, and therefore would normally fall under medical insurance as opposed to vision insurance. However, as each diagnosis and medical insurance have their own regulations about what is covered in each circumstance, it is impossible to give a standard answer to what is covered by every plan. Therefore, depending on the type of eye condition and plan, Medicaid may cover vision therapy.

Everyone's medical requirements are different. Vision insurance isn't right for everyone. However, for those who require more extensive vision care, a good insurance plan can save them a lot of money.

Learn More

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Testimonials

I haven't actually used the optometrist side, so my review is limited to the vision therapy offered. This office was recommended by my occupational therapist for the treatment of my double vision following a stroke.

Claire A.

Love this location. I had a brain injury accident from day one one. All the team make you feel you still important and hope in the horizon after when the medical system fell you miserably. Dr. Ikeda very professional and very understanding about your issue. Two tombs up.

Jim K.

My husband and I were immediately impressed with Dr Ikeda. I was hit by a car while cycling which caused broken bones and three brain injuries. The brain injuries caused double vision. Dr. Ikeda examined my eyes and got me started on vision therapy with his occupational therapist who specializes in vision therapy. She (Chris) is absolutely great. I am impressed with the array of tools used to help recover my binocular vision. I am doing things I never thought were possible (balance boards etc). Chris pushes me and keeps me motivated. I really enjoy my sessions with her. The office staff is always friendly and they have a wonderful appointment reminder tool that makes it easy to keep my calendar up to date. I am happy the rehab center at Little Co. of Mary recommended them!!

Teresa S.

The Vision Therapy is handled in a separate office through a different door from the shared waiting room. Chris, the vision therapist, has a wide and varied assortment of tools, equipment and resources to best evaluate and treat most vision issues. After just a few visits, my double vision became easier to control, using exercises developed during the therapy process. It was time well-spent.

Joe M.

I have been coming here since I can remember. I love it here. The staff is so amazing and nice. They explain everything they gonna do and never make you feel rushed. Dr. Ikeda has always been my doctor and I would never want another one. He is the doctor for my whole family and is always asking how everyone is doing. I am also so crazy about picking out my frames and have to try so many and each person who helps me take the time and lets me try them all on. I would never want to go anywhere else! I definitely would recommend this office to anyone looking for a great eye doctor.

Kayla W.

This is not for the eye exam but for the frames selection portion. I brought my prescription from Kaiser here with my VSP insurance. The reception staff was very polite and professional. Manny helped me to pick out frames and explain my coverage. Very helpful and patient not like the individual at the other place I rated here on Yelp. I was running late and he still helped me and was not bothered at all. I am so glad I came here ..........very pleased.

Very professional staff and pleasant.