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Vision Care Frequently Asked Questions

Find answers to question you may have on the Medi-Cal Vision Care program.  If you don't find the answer to your question below, contact Dr. Donny Shiu at vision@dhcs.ca.gov.

Starting July 26, 2010, Medi-Cal will again pay for you to get your eyes checked from an eye doctor if you are 21 years old or older. If you are younger than 21 years old or one of the people listed below in the exceptions, Medi-Cal already pays for your eyes to be checked.

                                                                                            

What will Medi-Cal now pay for?

Medi-Cal will now pay for these services if you are any age:

  • To see an eye doctor to test your eyes
  • To test for a prescription for eyeglasses
  • To test for a prescription for contact lenses if you have eye diseases
  • To check the health of your eyes
  • To check to see if you have low vision

 

What things will Medi-Cal NOT pay for?

Medi-Cal will not pay for these if you are 21 years of age or older (except in some cases):

  •  New eyeglasses or to fix your glasses
  • Contact lenses
  • Things that will help you see better (like magnifying glasses)

 

What are the exceptions?

Medi-Cal will pay for eyeglasses, contact lenses or other things to help you see better for only these people:

  • Pregnant women; and only if your doctor says that not having them will be harmful to your baby or pregnancy
  • Children or people less than 21 years old who have full Medi-Cal
  •  People who live in a nursing home

FAQs 

My vision is getting worse.  Can I have an eye exam to have it checked?

 Yes, you can obtain an eye examination from a Medi-Cal participating optometrist or opthalmologist in your area. You can access the following link to find an eye care provider in your area to schedule an appointment: Find A Vision Care Provider  

I Am An Eligible Beneficiary.  Where Can I Go To Get My Eyeglasses?

Many doctors have an optical dispensary in their office with a selection of frames for you to choose from. If not, then you can also take your eyeglass prescription to other participating optometrists, ophthalmologists or opticians in your area that have an optical dispensary to have your glasses made.  To find an optician, optometrist or opthalmologist in your county, go to the Find A Vision Care Provider  page.

I Need Eyeglasses to Read and Drive.  Can I Still Get Them?

 Only the eligible beneficiaries specified below are eligible to receive eyeglasses.

  •  Pregnant women; and only if your doctor says that not having them will be harmful to your baby or pregnancy
  •  Children or people less than 21 years old who have full Medi-Cal
  •  People who live in a nursing home

My Eyeglasses were Lost/Broken/Stolen.  Can I Have Them Replaced?

Only the eligible beneficiaries specified below are eligible for eyeglass replacement.

  •  Pregnant women; and only if your doctor says that not having them will be harmful to your baby or pregnancy
  •  Children or people less than 21 years old who have full Medi-Cal
  •  People who live in a nursing home

 

Are Contact Lens Covered Under The Medi-Cal Program?

No. However, the contact lens evaluation provided by an optometrist or ophthalmologist for medically necessary conditions remains a covered benefit under the Medi-Cal program.

I Am Visually Impaired.  Are There Any Services That Are Covered For Me Under The Medi-Cal Program?

The low vision examination remains a covered benefit and can be provided by a Medi-Cal participating optometrist or ophthalmologist in your area. Low vision aids, however, are not a covered benefit unless you are an eligible beneficiary specified above.

Does Medi-Cal Cover Prosthetic Eye Materials and Services?

Medi-Cal will cover prosthetic eye materials and services for those individuals that have lost an eye to disease or injury. A prescription from your doctor is required for the prosthesis to be covered.

What Are The Differences Between Opthalmalogists, Optometrists, and Opticians?

  • Ophthalmologists are medical physicians and surgeons who specialize in the diagnosis and treatment of eye disease. They also perform vision examinations and prescribe eyeglass lenses and contact lenses.
  • Optometrists are independent primary health care providers who examine, diagnose, treat and manage diseases and disorders of the visual system, the eye, and associated structures, as well as diagnose systemic conditions.
  • Dispensing opticians fill eyeglass and contact lens prescriptions

 

These eye-care practitioners are all providers under the Medi-Cal program.

    How Do I Find A Vision Care Provider In My County?

    Go to the Find A Vision Care Provider Page.

       

    Last modified on: 2/28/2014 10:53 AM