Here is good news many parents miss: because pediatric vision care is an essential health benefit under the ACA, children's routine eye exams and glasses are often already covered by your family's marketplace health plan. Before buying separate vision insurance for your kids, check what you already have.
What is typically covered
Exact benefits follow your state's benchmark plan, but children's vision coverage commonly includes:
- A routine eye exam, usually once a year
- Prescription glasses — frames and lenses — typically once a year
- Contact lenses in some plans or when medically necessary
Coverage usually applies until a child turns 19.
How it differs from children's dental
Children's dental can be offered separately from the medical plan, so many health plans do not include it. Children's vision, by contrast, is generally built into the medical plan. See children's dental coverage for how that works.
How to confirm your coverage
- Check the plan's Summary of Benefits and Coverage under children's eye exams and children's glasses.
- Look up in-network eye doctors and optical shops for the plan.
- Ask whether frames must be chosen from a covered collection.
When separate vision insurance still helps
- Your child wants frames outside the covered selection.
- Your child needs replacement glasses more than once a year.
- Your preferred eye doctor is not in the health plan's vision network.
- Adults in the household need vision coverage — adult vision is not an essential health benefit.
Compare whether it pays off in is vision insurance worth it?
Medicaid and CHIP
Children in eligible families can get vision coverage through Medicaid or CHIP. See our Medicaid eligibility guide.
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