Medi-Cal Vision Care Program

Medi-Cal Vision is a part of California’s Medi-Cal health care insurance program. The Medi-Cal Vision Program provides eye health care benefits to those who are eligible and live in California. While Medi-Cal vision coverage is available for people who are eligible for full-scope Medi-Cal, certain enrollees will have more covered services than others will. Medi-Cal vision benefits eligibility is contingent on entitlement to the California Medicaid enrollment as well as age. Depending on the California county where you reside, the available Medi-Cal vision plans may go by different program names.

Medi-Cal Vision Benefits Eligibility in California

Medi-Cal Vision benefits are only available to people covered by the full-scope Medi-Cal health care plan. Medi-Cal vision coverage can include children younger than 18 years of age, youths in or formerly in foster care (up to 26 years of age), people who are blind or disabled, pregnant women, seniors 65 years of age and older, people enrolled in CalWORKs and beneficiaries of Social Security Income (SSI). Since the aforementioned groups require different Medi-Cal vision services, beneficiaries enrolled in the program may have different covered services.

Find comprehensive information about vision care eligibility for the Medicaid program in California by downloading our comprehensive guide here.

Medi-Cal Vision Coverage for California Enrollees

Like other divisions of Medicaid in the state, the Medi-Cal Vision Program covers specific procedures and treatment related to eye health care. Children enrolled in Medi-Cal Vision benefit from more available services than adults do. The following Medi-Cal vision services are available to Medi-Cal beneficiaries:

  • Routine examination: Medi-Cal Visionbenefits include a routine eye exam every 24 months. During the exam, the ophthalmologist or optometrist will check the health of your eyes and test to see if you need an eyeglass prescription. If you do need eyeglasses, you may have to pay for them yourself. Only beneficiaries younger than 21 years of age and those living in residential nursing homes receive Medi-Cal Vision coverage for eyeglass frames and lenses.
  • Other tests: Your Medi-Cal vision services may include testing for contact lenses if you are unable to use eyeglasses dues to an eye disease or special condition. If you have a form of vision impairment that interferes with your ability to perform day-to-day activities and is not correctable by glasses, surgery, medicine or contact lenses, then you may be eligible for a low-vision eye test.
  • Other services: If you have lost one or both eyes due to injury or disease, then your Medi-Cal Vision Program may include services and materials for artificial eyes (ocular prosthetics).

How to Apply For California Medi-Cal Vision Benefits

If you wish to enroll in the Medi-Cal Vision Program, then you must first apply for Medi-Cal. The eligibility requirements for Medi-Cal vision coverage are the same as the Medicaid program in California. You may apply for Medi-Cal Vision in person by visiting your local county social services office. There you will be able to meet with agency personnel and get advice on your Medi-Cal application and assistance filling in the form. You can apply by mail by sending a completed application form to your local county social services office. Application forms are available in English and several other languages. You may also apply online at the Covered California website. Your online application will be directly transferred to your local county human services agency. If you are unable to visit your local office and you do not have internet access, then you can submit your Medi-Cal application over the phone by calling your local county human services agency.

Discover the eligibility requirements for enrolling in California Medicaid in a detailed state guide.

How to Find a Medi-Cal Vision Provider in California

Once Medi-Cal vision benefits eligibility, as well as Medicaid eligibility, have been determined by the state, you can make an appointment for vision care. Selecting a Medi-Cal vision provider starts by determining the correct doctor type for your needs. The Medi-Cal Vision Program coverage extends to many diverse vision specialist and applicants should select the provider according. Some of the Medi-Cal Vision eye care professionals include:

  • Optometrist: These Medi-Cal Visioneye care professionals are licensed to provide eye care services within the state of California. Their services include eye health examinations and vision tests as well as the diagnosis and treatment of eye disorders and diseases. An optometrist can offer a range of treatments including corrective eyeglasses, contact lenses and low-vision aids. In some circumstances, they may also perform minor eye surgery.
  • Ophthalmologist: Ophthalmologists associated with the Medi-Cal Vision Program are medically trained doctors who specialize in total care of the eyes, prevention of eye disease and treatment of eye injuries. As well as providing primary services, they may also provide vision services including eye health examinations, visual tests, medical care and surgical care.
  • Optician: A Medi-Cal Vision optician is an eye care professional who can fill out your corrective eyeglasses or contact lens prescription once it is written out by the ophthalmologist or optometrist. An optician can also provide you with prosthetic eyes or low-vision aids.
  • Ocularist: This type of eye care professional is one who specializes in making and fitting prosthetic eyes. You will need to see an ocularist if you have lost one or both of your eyes due to injury or illness.

Before choosing a provider from the directory, make sure you can find one that is in your area and close enough for you to travel. Before you go to your eye exam, make sure you have your Medi-Cal Vision Benefit Identification Card (BIC) and another form of identification with you, such as your driver’s license or California-issued ID card.

Download our comprehensive California guide for specific information about state programs available for qualified residents.

What Are the Available Health Services in California?

Low-cost, and even free health benefits are available to a large number of California residents, with some being offered to low-income applicants and others being offered to elderly or disabled individuals. However, before you can access these health services, you need to submit the appropriate application and prove that you meet the necessary qualifications. To learn all about the different health benefits you can receive in California and the application procedures that you must undergo to obtain these benefits, download our free comprehensive guide.

Who Is Eligible to Obtain California Health Benefits?

California’s health programs have various eligibility requirements that applicants must meet in order to successfully enroll. Income, age and other factors are all taken into consideration in the eligibility verification process. Find out which health benefits you qualify for here.