Eyeglass Coverage
Applicable To: Mercy Care Complete, Mercy Care RBHA, Mercy Care DD, Mercy Care Long Term Care and Mercy Care DCS CHP
Did you know Mercy Care covers eyeglasses and replacements for children and youth. Vision services for Mercy Care members include regular eye exams and vision screenings, prescription eyeglasses, and repairs or replacements of broken or lost eyeglasses.
What if the glasses are lost or broken?
There are no restrictions for replacement eyeglasses when medically necessary for vision correction. This coverage includes, but is not limited to, loss, breakage or change in prescription.
How can caregivers get glasses or replacement glasses?
They do not need to wait until the next regularly scheduled vision screening to replace or repair eyeglasses. If the child/youth in their care breaks or loses their prescribed eyeglasses, an appointment needs to be scheduled for a vision screening with the child/youth’s healthcare provider.
As a reminder, federal law [42 USC 1396d(a)] requires Medicaid to cover all services when medically necessary and cost effective for Mercy Care members. This means that Mercy Care will cover these health services if the treatment or service is necessary to “correct or ameliorate” defects or physical and behavioral illnesses or conditions
Mercy Care is committed to ensuring the availability of timely, quality healthcare. If a caregiver is unable to access health services for the child/youth in their care, or if they have a concern about the quality of care, please support them in calling Mercy Care Member Services at 602-212-4983 or 1-833-711-0776 (TTY/TDD: 711). If their concern is not resolved, please support them in calling AHCCCS Clinical Resolution Unit at 602-364-4558, or 1-800-867-5308.
We appreciate your continued assistance, support and cooperation!
