Navigating Your Child’s Vision Benefits 

Texas Eyecare can be a hard landscape to navigate. This page helps you understand where to start and which benefits to use by answering these questions: 
  1. My child failed a screening. What now?
  2. What is the difference between vision and medical eye benefits?
  3. Who provides my child’s benefits?
  4. How do I find the correct vision plan and doctor?
  5. Where can I ask for help

My Child Failed a Vision Screening.
What now?

If your child fails a vision screening, they should receive a comprehensive eye examination. Unfortunately, vision screenings can still miss some vision and eye health issues. The American Optometric Association also recommends that ALL school age children receive an annual comprehensive eye exam. Luckily, with most Medicaid plans, there is an annual benefit for your child’s eye exam. Texas Medicaid generally covers eye examinations and medically necessary glasses for children. The company that helps provide those services may be different from the Medicaid health plan listed on your child’s insurance card.

Traditional Vision Insurance

Schedule a comprehensive eye exam for your child

Find an optometrist in your community
Medicaid Coverage

Continue reading this page for more information on navigating Medicaid for your child.

Need Financial Assistance?

Here’s a list of resources available to you:

Next Steps:

1. Schedule a comprehensive eye examination

A school screening is not the same as a complete eye examination. Tell the eye doctor’s office that your child failed a school vision screening.

2. Have your child’s Medicaid card available

The office may need both the Medicaid health-plan information and the name of the vision company that manages routine eye care.

3. Bring the screening referral or results

Bring any letter or screening results provided by the school nurse.

4. Ask when glasses will be ready

When glasses are prescribed, ask where they will be ordered, when they should arrive and whom to contact if they are lost or broken.

5. Share the examination results with the school

Return any requested documentation to the school nurse so the school knows that follow-up care was completed.

What is the difference between vision and medical eye benefits?

Texas Medicaid covers both routine vision services and medical eye care, but they may be handled differently.

Vision benefits

Use your child’s vision benefit when your child:

  • Failed a school vision screening
  • Needs a routine or comprehensive eye examination
  • Has blurry vision or difficulty seeing the board
  • May need glasses
  • Needs replacement glasses
  • Needs medically necessary contact lenses

The vision benefit is often administered by a separate vision company, such as Superior Vision, VSP, March Vision, NVA, Davis Vision, Envolve Vision or another contracted company.

Vision Benefit
  • Failed screening
  • Eye examination
  • Glasses
  • Blurry vision
  • Vision plan manages benefit

Medical eye benefits

Use your child’s Medicaid medical benefit when your child has:

  • A red, painful or irritated eye
  • An eye infection or severe eye allergies
  • An eye injury
  • Sudden changes in vision
  • Diabetes or another medical condition affecting the eyes
  • Glaucoma, cataracts, retinal disease or another diagnosed eye condition

Medical eye care is provided through the child’s Medicaid managed care organization, or MCO, such as Aetna Better Health, Cook Children’s Health Plan, Molina, UnitedHealthcare, Wellpoint or another regional Medicaid plan.

Medical Eye Benefit
  • Red or painful eye
  • Eye injury
  • Infection or allergies
  • Diabetes-related eye care
  • Medicaid MCO manages benefit

Important message

The same optometrist may be able to provide both routine vision care and medical eye care. However, the office may need information from both your child’s Medicaid health plan and vision plan.

Who provides my child’s vision benefits?

Click on your Managed Medicaid Health Plan to see vision plan details:

Aetna Better Health

Vision plan: Superior Vision

Find an eye doctor: Search Provider Directory

Call the vision plan: 1(800)507-3800

Transportation: MTM Health Link  at 1-866-411-8920

Learn More >

Blue Cross and Blue Shield of Texas

Vision plan: Davis Vision

Find an eye doctor: Search Provider Directory

Call the vision plan: 1(800)999-5431

Transportation: mymodivcare.com  at 1-866-824-1565

Learn More >

Cook Children’s Health Plan

Vision plan: NVA

Find an eye doctor: Search Provider Directory

Call the vision plan: 1(800)672-7723

Transportation: MTM Health  at 1-844-572-8195

Learn More >

Community First Health Plans

Vision plan: To be confirmed* Cannot identify vision plan

Find an eye doctor: Search Provider Directory

Call the vision plan: 1(855)607-7827

Transportation: SafeRide Health  at 1-855-932-2335

Learn More >

Driscoll Health Plan

Vision plan: Centene – Envolve Vision

Find an eye doctor: Search Provider Directory

Call the vision plan: 866-838-7614 or 877-615-7729

Transportation: SafeRide Health  at 833-694-5881

Learn More >

Molina Healthcare

Vision plan: VSP

Find an eye doctor: Search Provider Directory

Call the vision plan: 844-859-5870

Transportation: SafeRide Health  at (866)462-4857

Learn More >

Superior HealthPlan

Vision plan: Centene – Envolve Vision

Find an eye doctor: Search Provider Directory

Call the vision plan: 1-866-897-4785

Transportation: SafeRide Health  at 1-855-932-2318

Learn More >

Texas Children’s Health Plan

Vision plan: Centene – Envolve Vision

Find an eye doctor: Search Provider Directory

Call the vision plan: 844-683-2305

Transportation: SafeRide Health  at 888-583-0110

Learn More >

UnitedHealthcare Community Plan

Vision plan: March Vision

Find an eye doctor: Search Provider Directory

Call the vision plan: (844)976-2724

Transportation: Where’s My Ride at 1-888-462-6050

Learn More >

Wellpoint

Vision plan: Superior Vision of Texas

Find an eye doctor: TBD

Call the vision plan: 800-428-8789

Transportation: MTM Health at 833-721-8184

Learn More >

How do I find the correct vision plan and doctor?

Don’t See Your Child’s Medicaid Plan?

Texas Medicaid plans and vision-provider arrangements may vary by location and program. The Texas Optometric Association can help you:

  • Identify the vision plan connected to your child’s Medicaid coverage
  • Locate the appropriate provider directory
  • Understand general eye-exam and glasses benefits
  • Find the correct transportation contact
  • Identify whom to contact when you are having difficulty accessing care
Ask TOA About My Child’s Vision Benefits

The Texas Optometric Association helps families understand Medicaid vision benefits and connect with appropriate resources.

TOA does not determine Medicaid eligibility, authorize benefits or guarantee coverage, but we can help you identify the right health plan, vision plan or contact for your question.

Many Texans struggle because they can’t afford to see a specialist or don’t have access to one nearby, but also can’t afford to suffer with worsening eye disease as they try to work, drive, and care for their families.

Megan Collins, OD

Texas needs to modernize its laws, so I can properly take care of my patients.

Cynthia Fleitman, OD
READ MORE
Privacy Settings
We use cookies to enhance your experience while using our website. If you are using our Services via a browser you can restrict, block or remove cookies through your web browser settings. We also use content and scripts from third parties that may use tracking technologies. You can selectively provide your consent below to allow such third party embeds. For complete information about the cookies we use, data we collect and how we process them, please check our Privacy Policy
Youtube
Consent to display content from - Youtube
Vimeo
Consent to display content from - Vimeo
Google Maps
Consent to display content from - Google
Save