Eye and Vision Care

OHP covers medical eye exams for any eye condition. Diagnostic services are also covered.

OHP covers routine vision exams for "disorders of refraction and accommodation" (e.g., nearsightedness, farsightedness, astigmatism):

• Once every 24 months for adults age 21 or older.
  
• When clinically appropriate for OHP members under age 21, pregnant adults, and OHP members with Young Adults with Special Health Care Needs benefits.
  

Glasses or Contact Lenses

OHP covers glasses, fittings for glasses or contact lenses when clinically appropriate for:

• Pregnant adults (age 21 and older), and 12 months postpartum,
  
• Children under age 21 and
  
• OHP members with Young Adults with Special Health Care Needs benefits.
  

For non-pregnant adults (age 21 and older), OHP covers glasses or contact lenses for only these specific medical conditions:

• Aphakia, pseudoaphakia, congenital aphakia, keratoconus; or
• The natural lenses of the eye are missing; or
• Has had a keratoplasty surgical procedure (e.g., corneal transplant). For this condition, OHP only covers contact lens services and supplies.
  

Other vision services need to be approved by OHP or your coordinated care organization (CCO).

To Get Eye or Vision Care:

If you are in a CCO that covers your physical health care, call your CCO. 

If you are not in a CCO for your physical health care, try these resources:

• Call OHP Care Coordination at 800-562-4620.
  
• Use the online provider search.
  

Eye/Vision Care Links

Free or low-cost eye care (National Eye Institute)

Rules about covered services:

• Visual services