For the past decade, low-income adults on the Medi-Cal program have been covered for visual exams and other eye services, but not eyeglasses themselves. They’ve had to pay for those out of pocket, along with other excluded benefits such as podiatry, some hearing services and incontinence treatments.
But starting in 2020, these benefits are back on the list.
The federal government considers some services “optional” for Medicaid patients. So they were the first to go when California needed to shrink the Medi-Cal budget in 2009, said Jedd Hampton, director of policy at senior advocacy group LeadingAge California.
“Across the board these services, though they’re seen as optional benefits, they provide a whole wraparound element for the overall wellness of that individual,” he said, noting that seniors were hit especially hard by the benefit cuts.
The latest state budget allocates $17.4 million to cover eyeglasses, podiatry, audiology and other benefits starting Jan. 1.
This is the next step in an ongoing process of restoring previously cut Medi-Cal benefits. The state has restored dental coverage in recent years, and acupuncture has also returned as a covered service.
But the lack of vision services has remained a problem. Roughly 2 million Medi-Cal enrollees between ages 21 and 64 need glasses, according to the California Optometric Association. Children and people living in nursing homes are currently covered for glasses.
“Those that had the ability to get glasses were able to perform their work functions better, they were able to drive more effectively, and read better,which is really unfair, unfortunately,” said David Ardaya, chairman of the association’s health care delivery systems committee. He added that people are more likely to seek routine eye exams if they know eyeglasses will be covered.
The need for eyeglasses is likely to continue as more Californians develop diabetes, which can cause eye disease. Patients with diabetes are also more likely to need toe or foot amputations, which require soon-to-be-covered podiatric care.
The Department of Health Care Services says it plans to notify all Medi-Cal providers and beneficiaries about the newly covered services.
CapRadio provides a trusted source of news because of you. As a nonprofit organization, donations from people like you sustain the journalism that allows us to discover stories that are important to our audience. If you believe in what we do and support our mission, please donate today.