Understanding My Child’s Vision Health Insurance

Understanding My Child's Vision Health Insurance

Children’s vision services are covered on most insurance plans and many are free. Vision services include screening by a healthcare provider, a complete eye exam by an eye doctor (optometrist or ophthalmologist) and if recommended by the eye doctor, treatment (corrective eye glasses, patches, eye drops or surgery).

Find out more about your child's vision coverage below:

I have health insurance through AHCCCS (Medicaid)

AHCCCS (Medicaid)

AHCCCS (Arizona Health Care Cost Containment System) oversees the Arizona Medicaid program that provides healthcare coverage for qualified participants.

If you child is enrolled in AHCCCS, he/she is eligible to receive a vision screening, a complete eye exam by an eye doctor, and if needed, treatment for an eye condition. All AHCCCS insurance plans must provide these vision services FREE of charge for children under age 21.

Contact your AHCCCS insurance plan for more information, or contact AHCCCS directly:

I have health insurance through KidsCare

KidsCare:

KidsCare is an AHCCCS program that provides health care coverage to children under age 19. KidsCare is for children who do not have health insurance and do not qualify for Medicaid. Families must pay a monthly premium.

If your child is enrolled in KidsCare he/she is eligible to receive a vision screening, a complete eye exam by an eye doctor, and if needed, treatment for an eye condition without a required co-pay.

Contact your KidsCare insurance plan for more information, or contact AHCCCS directly:

I have health insurance through my employer/the marketplace

Other insurance coverage:

If your child is enrolled in an insurance plan under the Affordable Care Act (ACA) marketplace, he/she is qualified to receive a vision screening, a complete eye exam by an eye doctor, and if needed, treatment for an eye condition. Vision services are considered one of the 10 essential benefits, and must be provided for your child under these plans. However, your family may need to pay a co-pay or meet a deductible amount for these services.

Most other private insurance plans also provide coverage for children’s vision services, including a vision screening, a full eye exam by an eye doctor, and if needed, treatment for an eye condition. However, your family may need to pay a co-pay or meet a deductible amount for these services.

Contact your insurance plan for more information.

I don't have insurance

No insurance coverage or need financial assistance

If your child does not have health insurance coverage for vision services, or financial help is needed for vision services for your child, the following programs may be able to assist:

  • Arizona Lions Vision Center (nonprofit in Phoenix and Tucson that provides free or low-cost vision screening and glasses for those in need and age 6 and older):
  • Toll-free: 877-275-5778
  • http://arizonalionsvisioncenter.org/
  • Infant See (national program for children between 6-12 months):
  • http://www.infantsee.org
  • Sight for Students (national program from Vision Services Plan that distributes vouchers for eye exams and glasses through local schools and other partners):
  • http://sightforstudents.org

Vision Insurance Coverage for Adult Family Members and Caregivers

Healthy vision is important for the adults in the family too. Many healthcare insurance plans do not cover vision services for adults. However, it is important for adult family members and caregivers to have regular eye exams and to follow up on the treatment plans recommended by eye doctors. Adults may consider purchasing a separate vision services insurance plan to maintain good vision health.