Does Medicaid cover eyeglasses?
The answer is yes—sometimes. Medicaid is federally required to cover eyeglasses for children in every state.
However, for adults aged 21 and over, vision coverage under Medicaid will vary based on where you live and the type of care you require. Here’s what you need to know about Medicaid and vision coverage.
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When does Medicaid cover glasses and vision care?#when-does-medicaid-cover-glasses-and-vision-care
Similar to dental care, Medicaid covers 100% of the cost of vision care for children and young adults aged 21 and younger under Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefits. This coverage does not change based on the state; it is required under federal law.
Under EPSDT, Medicaid covers the cost of the following vision care for kids:
- Eye exams
- Eyeglasses
For people enrolled in Medicaid who are age 21 and over, much of vision care is optional under federal law.
Generally, you can expect Medicaid to cover eye eye injuries and diseases, as well as eye conditions and symptoms related to a vision illness.
However, out of the 6.5 million Americans enrolled in Medicaid, 12% live in states that do not cover basic vision needs for adults, including routine eye exams, according to an NIH analysis from 2024.
Some states will cover the cost of eyeglasses or contacts, but only if they’re required for corrective reasons, not for cosmetic purposes. Additionally, Medicaid in some states may cover only some types of glasses, with patients paying the difference depending on design preference.
When it comes to check-ups, Medicaid should cover basic eye exams in every state, but the frequency may vary. Some states may cover the cost of an exam annually, while others cover the cost only every three years.
While your state Medicaid program may not completely cover the cost of vision care, you may only have to pay a small copay for the service, depending on your coverage. Check with your state Medicaid office for more information.
What Medicaid does (and doesn’t) cover#what-medicaid-does-and-doesnt-cover
Under Medicaid, you typically won’t pay a monthly premium for coverage. You can expect Medicaid to cover the cost of many types of car services, including:
- Hospital stays
- Outpatient doctor visits
- Preventative care
- Prenatal care
- Nursing facility services
- Home health services
- Coverage for children
Depending on your state, you may have small copays for some treatments, including:
- Prescription medications
- Emergency room visits
- Inpatient stays
The cost of a copay is capped under federal law, so even if you have to pay them, these copays are likely to be only a few dollars.
