Medicaid Vision Insurance in Pennsylvania

Medicaid vision insurance in Pennsylvania is primarily available for children. However, there may be some limited Pennsylvania Medicaid vision benefits available for adults as well, depending upon the condition. Medicaid vision benefits vary from state to state, with many states offering no coverage at all. Some Pennsylvania Medicaid vision insurance provides vision examinations free of charge, but there may be fees for other types of care and corrective lenses. In Pennsylvania, Medicaid is known as Medical Assistance. Every state may call their Medicaid program a different name, and Medicaid benefits vary from state to state, but all Medicaid programs in every state are operated in collaboration with the federal government. Some states have no Medicaid vision insurance, while others offer vision coverage for children only. Some provide limited Medicaid vision insurance benefits for eligible adults. PA Medicaid vision coverage primarily serves low-income children and adolescents to ensure they get the vision screening services and care they need. Continue reading below to learn about Medicaid vision insurance eligibility requirements and the steps you need to take to enroll in the program.

What does PA Medicaid vision insurance cover?

Pennsylvania Medicaid vision care may be included under your Medicaid insurance coverage. Different Medicaid vision plans have different benefits, depending upon your income eligibility, age and the type of plan you have. Medical assistance vision coverage for children is more comprehensive than it is for adults. With PA Medical Assistance vision insurance, depending upon your plan, you and your family may be eligible for:

  • Two eye-health vision exams per year
  • Daily-wear contacts or standard glasses with in-plan frames
  • If younger than 21 years of age, up to four lenses and two in-plan frames per year
  • Out-of-plan frames up to $20
  • Prescription medications
  • Other medically necessary services and materials

Medicaid vision insurance in Pennsylvania allows you to seek services from a range of vision specialists, depending upon your vision needs, including:

  • Optometrists
  • Ophthalmologists
  • Opticians
  • Ocularists

Each of these vision professionals provides different types of treatment. Pennsylvania Medicaid vision care will enable you or your family to receive the kind of care you need. Medical Assistance vision benefits in PA may include small fees for services and materials, such as corrective lenses. Medicaid vision benefits for children are more comprehensive than those for adults. Vision coverage for adults may be covered only for specific eye conditions.

Pennsylvania Medicaid Vision Insurance Eligibility Requirements

Eligibility requirements for Medicaid insurance vision in PA follows the same guidelines as other Medicaid coverage. Income is the primary factor in determining both individual and family eligibility. For adults to be eligible for Medicaid Vision Insurance in Pennsylvania, an applicant's income must be lower than a certain amount of the federal poverty level. Household income is calculated using a Modified Adjusted Gross Income (MAGI) system, in order to determine both level of need and the best type of plan to fit your income level and family size. In calculating Medicaid eligibility requirements, certain types of income are not included, including Supplemental Security Income (SSI), contributions to retirement accounts, child support, disability benefits, and others.

Vision care for children under the Medicaid Children's Health Insurance Program (CHIP) is more comprehensive than adult vision care. Under some Medical assistance vision benefits plans, only adults with certain types of vision problems are eligible for benefits. For more specific information about Medicaid vision insurance in Pennsylvania, you can download our comprehensive guide today.

How to Enroll in PA Medicaid Vision Insurance

To apply for Pennsylvania Medicaid vision benefits, you must follow the same procedure as applying for other Medicaid Benefits in PA. To enroll in Medicaid vision insurance coverage, you will first need to apply for Medicaid. You will need to have a number of documents on hand in order to fill out the application, including your income and financial resources and the birthdates for all household members included in your application, among other information and documentation. It is important that all information you provide in your PA Medicaid vision care application is accurate, as your application will be reviewed by state officials to determine eligibility for Medicaid vision and other benefits.

You have several different options for completing and submitting your application:

  • Online
  • By mail
  • By phone

After you submit your application, you should be notified within 30 days as to what Medical Assistance benefits you qualify to receive. For more information on Medicaid vision insurance requirements and how to apply for Medical Assistance vision insurance in Pennsylvania, you can download our comprehensive guide.

Secure

What Health Services Are Available in Pennsylvania?

From Obamacare health insurance plans to Medicaid and Medicare, there are various types of health coverage available in Pennsylvania. Each type of insurance can be accessed through a different application method. To learn about the easiest ways to apply for affordable health care in GA, download our comprehensive guide on health services.

Who Is Eligible for Affordable Health Services in Pennsylvania?


Affordable and free health services are often limited to Pennsylvania residents who meet all established eligibility requirements. Income, age and household size are often key factors taken into consideration when determining an applicant’s qualifications. Discover if you qualify for free or reduced-cost health insurance by reviewing the in-depth information on all program eligibility requirements within our comprehensive guide.