Eye Exams Now Part of Essential Health for Children

Did you get your child a back-to-school eye examination yet? If not, there’s something you should know. Effective this year, under the rules of the new Patient Protection and Affordable Care Act’s pediatric essential eye health benefit, a comprehensive eye examination for your child annually is now covered by insurance.

What does this mean?

Well, I learned that first hand when I took my seven year old to his annual well-child visit last week. His eyes were tested in the vision screening but the doctor also requested he get a full eye examination and explained to me the coverage. It used to be that vision exams were treated separately and only covered if you had an additional insurance plan specifically for vision. Now, your medical insurance will reach across that invisible line and cover eye exams for kids.

Group Insurance Plans

If your insurance plan is an individual or small group plan with 50 or fewer employees at the start of this year, your provider was required to provide pediatric vision care coverage as a medical benefit for any children on the plan age 19 or younger. Starting in January of 2016, individual and small group plans with 100 or fewer employees will also be forced to comply. Large group plans, plans purchased before March 2010 and self-insured plans are not required to offer this but, if they do, the coverage must be a part of the medical plan.

Individual Insurance Plans

If you have a stand alone vision plan, check with your provider as to what is covered. The eye exam for your child should be as a part of this new law, but any eyeglasses, contacts, or other vision correction resources may not be. This varies between vision plans. But, don’t worry, America’s Best offers great prices on designer eyeglasses and name brand contact lenses, so you may do better taking advantage of America’s Best sale pricing than using your insurance anyway. What’s most exciting about this new law is that it means that no longer will children miss out on the vision care they need because of expense! The government has recognized the necessity of children having quality vision care so that they can thrive in school and learn well. If you have any questions about this new law or need to get your children an eye exam this month, please call your closest America’s Best retailer and they can explain the benefit and schedule your exams.

You may also like...