Access and Coverage
Medicaid and the Children's Health Insurance Program



Medicaid is an insurance program that is overseen by the federal government and managed by states and covers health care costs for people with low income and resources. The Patient Protection and Affordable Care Act (ACA) allowed for states to expand their Medicaid program eligibility standards to allow more people to be covered. The federal government establishes guidelines and criteria for states to follow when designing and administering Medicaid plans and, so long as states comply with federal guidelines, states receive matching federal funds to offset costs of administering their programs.

Every state Medicaid plan offers varying levels of coverage based on different eligibility standards and criteria; thus, what is offered in one state may not necessarily be offered in another. Eye health services such as vision screenings, eye examinations, eyeglasses, and medical or surgical procedures, are considered covered services under Medicaid and CHIP for children under the age of 21. Typically, states determine if vision benefits are covered and what kind of vision and eye health services for adults are offered under their own Medicaid programs. Prevent Blindness encourages states to consider vision and eye health as a part of overall health, and to integrate vision into appropriate disease and behavioral (such as smoking cessation) interventions.


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