Navigating vision care coverage can be confusing, especially when using Medicaid. If you’re seeking Eye Care Places That Take Medicaid, understanding your benefits is the first step. This guide explains the vision services covered under Health First Colorado (Colorado’s Medicaid program), ensuring you know what’s available for you or your family. Benefits differ based on age, so let’s clarify the specifics for both children and adults.
Vision Benefits for Children and Adults Under Health First Colorado
Health First Colorado provides distinct vision benefits depending on age. Here’s a breakdown to help you understand your coverage:
For Children (Age 20 and Under):
Children enrolled in Health First Colorado receive comprehensive vision benefits through the Early Periodic Screening Diagnosis and Treatment (EPSDT) program. This includes:
- Eye Exams: Regular eye examinations to monitor vision health.
- Eyeglasses: Standard eyeglasses, including frames and lenses (single or multi-focal).
- Eyeglass Repair and Replacement: Coverage for repairs due to breakage and replacements when medically necessary or if repairs are not cost-effective.
- Contact Lenses: Contact lenses are covered when deemed medically necessary.
- Ocular Prosthetics: Coverage for ocular prosthetics when medically necessary.
- Low Vision Aids: Support for low vision aids to assist with visual impairments.
For Adults (Age 21 and Older):
Adults under Health First Colorado are also entitled to vision care, though the coverage specifics are different:
- Annual Eye Examinations: Yearly eye exams are covered to maintain eye health.
- Eyeglasses and Contact Lenses (Post-Surgery): Eyeglasses (single or multi-focal plastic lenses and one frame) and contact lenses are covered only after eye surgery. It’s important to note that this benefit applies regardless of when the eye surgery occurred in your life.
It’s worth noting that if you are enrolled in a managed care plan through Health First Colorado, you might have access to additional vision benefits beyond those listed here. Always check with your specific plan for a complete understanding of your coverage.
Frequency of Eyeglass Replacement and Repair Under Medicaid
Health First Colorado ensures you have access to necessary vision correction. Here’s what you need to know about repairs and replacements:
- Eyeglass Repair: Medicaid covers the repair of eyeglasses when frames or lenses are broken.
- Eyeglass Replacement: Replacement eyeglasses are provided when medically necessary or if your current glasses are damaged beyond cost-effective repair.
Finding Eye Care Places That Accept Medicaid
To access these vision benefits, you’ll need to find eye care places that take Medicaid. The best first step is to contact the Health First Colorado Member Contact Center. They can provide you with the most up-to-date information on providers in your area who accept Medicaid and can help you understand any specific requirements or steps you need to take to utilize your vision benefits.
Get Help:
For further assistance and to find eye care places that take Medicaid, reach out to the Member Contact Center:
