Gaps Identified in Medicaid Provision of Routine Vision Care

Most fee-for-service Medicaid programs cover routine eye exams, but many do not cover glasses or low vision aids

By Elana Gotkine HealthDay Reporter

FRIDAY, Aug. 9, 2024 (HealthDay News) — Although most fee-for-service Medicaid programs cover routine eye exams, many do not cover glasses or low vision aids, according to a study published in the August issue of Health Affairs.

Brandy J. Lipton, Ph.D., from the University of California in Irvine, and colleagues detailed Medicaid policies for 2022 and documented variability in coverage for adult vision services by state.

The researchers found that routine eye exams were covered by most fee-for-service Medicaid programs, although many did not cover glasses or low vision aids (20 and 35 states, respectively). Enrollee cost sharing was required by about two-thirds of states with routine coverage. Relative to fee-for-service programs, managed care plans generally provided consistent or enhanced coverage, although sometimes there was between-plan variation in coverage within a state. About 6.5 and 14.6 million adult enrollees were estimated to reside in states without comprehensive coverage for routine eye exams and glasses, respectively.

“Our study clearly shows that there are opportunities to expand coverage of routine vision services at the state level, and based on previous research, we expect more generous coverage would reduce rates of vision impairment, improve quality of life, and promote health equity,” Lipton said in a statement.