Insurance
Children’s vision services are covered by most insurance plans, and many services are free. Covered services include vision screening by a healthcare provider, a complete eye exam by an eye doctor (optometrist or ophthalmologist), and corrective treatment, if recommended, including eye glasses, patches, eye drops, or surgery.
Insurance options for children’s vision services
Children’s vision services from healthcare providers are covered under most insurance plans, including AHCCCS (for children under age 21), KidsCare (for children under age 19); and most private insurance plans, including those offered through employers or the Affordable Care Act (ACA) marketplace. There are also options for Arizona families without insurance.
AHCCCS/Medicaid
AHCCCS (Arizona Health Care Cost Containment System, often referred to as ‘access’) is Arizona’s Medicaid program. Medicaid is a healthcare insurance program jointly funded by the federal government and states for individuals and families who qualify based on income level.
AHCCCS insurance plans provide coverage for vision services, free of charge, for children under age 21. Children enrolled in AHCCCS are eligible to receive a vision screening, a complete eye exam by an eye doctor, and if needed, treatment for an eye condition.
Learn about AHCCCS health insurance plans or contact AHCCCS for more information.
KidsCare/CHIP
If a child’s family income is too high to qualify for AHCCCS health insurance, they may be eligible for coverage through KidsCare, Arizona’s Children’s Health Insurance Program (CHIP). KidsCare is for children under age 19 and requires a low monthly premium.
Children enrolled in KidsCare are 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 copay.
Learn more about Kidscare, including eligibility, income limits, and premiums, as well as available health plans.
Employer-Sponsored Health Plans
Many Arizona children are covered by private health insurance plans offered by employers of a parent. Most private insurance plans 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. Families may need to pay a copay or meet a deductible amount for these services.
Contact your employer-sponsored insurance plan for more information about children’s vision services.
Health Insurance Marketplace (ACA)
Arizona families can also access insurance through the Health Insurance Marketplace, also known as the Affordable Care Act (ACA) Marketplace. Children enrolled in Marketplace insurance plans are qualified to receive a vision screening, a complete eye exam by an eye doctor, and if needed, treatment for an eye condition. (Pediatric vision care services are one of the 10 essential health benefits covered by all plans offered in the Health Insurance Marketplace.) However, families may need to pay a copay or meet a deductible amount for these services.
Learn more about insurance options available through the Health Insurance Marketplace or contact your ACA insurance plan for more information about children’s vision services.
Options for families without health insurance
Vision services are also available for children in Arizona not covered by any health insurance and those who need financial assistance.
Vision screening in Arizona public schools
All Arizona public and charter schools are required to provide vision screenings for enrolled children at school entry (pre-K or kindergarten), in third grade, and again in seventh grade. These screenings do not require insurance and are provided for free. Vision screening may also be provided at child care and preschool programs, Head Start, and home visiting programs.
Learn more about where children can get vision screening.
Free and low-cost eye exams and treatment
Children who don’t pass a vision screening are referred to an eye doctor for a complete eye exam. It is important for them to be checked by an optometrist or ophthalmologist to see if they have a vision problem and need treatment, such as eye glasses.
Paying for these services may be hard for some families, but there are ways to get free or low-cost eye care for children who need it.
These programs may be able to help children without health insurance or those in need of financial assistance:
- Arizona Lions Vision & Hearing Foundation provides free or low-cost vision screening, eye exams, prescriptions, eye glasses, and surgeries for those in need, including a mobile eye unit that visits schools and other locations in communities across Arizona.
- EyeCare4Kids, Arizona offers free, professional eye exams, vision screening, and glasses or contact lenses, when needed, for children from low-income, underserved families.
- Optometrists who participate in the Infant See program provide no-cost, comprehensive eye and vision assessments for infants 6-12 months old, regardless of a family’s income or access to insurance coverage. Use their find a doctor search tool to look for participating optometrists in your area.