Medicaid covers glasses through eye doctors and optical retailers, but not all providers take Medicaid in your state

Medicaid pays for eyeglasses through two main routes: optometrists and ophthalmologists (the doctors), and optical shops or chains that fill prescriptions. However, whether a specific provider accepts Medicaid depends on your state's program and that provider's contract with Medicaid. A large chain like Walmart Vision or LensCrafters may accept Medicaid in one location and not in another, or accept it in one state but not yours.

The fastest way to find providers near you is to call your state Medicaid office or check your Medicaid member card, which usually lists a phone number for customer service. They can tell you which eye doctors and optical shops in your area are in-network — meaning they have agreed to accept Medicaid as payment. You can also ask your primary care doctor for a referral to an eye doctor who takes Medicaid.

If you go to a provider who does not take Medicaid, you will pay out of pocket and will not be reimbursed. Medicaid does not work like insurance where you can submit a claim later; the provider must be enrolled in Medicaid before your visit.

Key Takeaways

  • Your state Medicaid program maintains a list of in-network eye doctors and optical retailers; call the number on your member card to find providers near you.
  • Large chains like Walmart, LensCrafters, and Costco accept Medicaid in some locations and states but not others, so you must confirm before your appointment.
  • Medicaid typically covers an eye exam and one pair of glasses per year, though coverage details vary by state.
  • If you visit a provider who does not take Medicaid, you will pay full price and cannot file a claim for reimbursement later.

How to find an in-network eye doctor

Start by calling the customer service number on your Medicaid member card. Tell them you need an eye doctor or optometrist who takes Medicaid in your area. They can give you a list of names, addresses, and phone numbers. Many state Medicaid programs also have online directories where you can search by zip code, though the online lists are sometimes outdated, so a phone call is more reliable.

If you do not have your member card, contact your state Medicaid office directly. You can find your state office through the Centers for Medicare & Medicaid Services website or by searching "[your state] Medicaid" online. Some states run Medicaid through a managed care plan (like a health maintenance organization), in which case you would call that plan's customer service number instead of the state office.

Ask the person on the phone whether the doctor you want to see is in-network and whether you need a referral from your primary care doctor before your visit. Some Medicaid plans require a referral for specialist visits; others do not.

Which optical retailers accept Medicaid

Large chains including Walmart Vision Center, Costco Optical, LensCrafters, and Pearle Vision have Medicaid contracts in many states, but availability varies widely. A Walmart Vision Center in one town may take Medicaid while the one 20 miles away does not. The same is true for Costco and other chains.

Independent optical shops in your area may also accept Medicaid. These are often easier to reach by phone than chain customer service lines. Call ahead and ask whether they take Medicaid and whether they have an opening for a new patient.

Do not assume a retailer takes Medicaid based on size or reputation. Always confirm before you go in or schedule an appointment. If you show up without confirming and the store does not take Medicaid, you will be asked to pay the full cost of the exam and glasses.

What Medicaid covers for glasses

Medicaid typically covers an eye exam and one pair of eyeglasses per year. Some states cover contact lenses instead of glasses, or allow you to choose between the two. A few states cover both glasses and contacts, but this is less common.

Coverage for frames and lenses varies by state. Some Medicaid programs cover a standard frame and single-vision lenses with no out-of-pocket cost. Others set a dollar limit on frames (for example, $150) and require you to pay the difference if you choose a more expensive frame. Bifocals, progressive lenses, and specialty coatings may or may not be covered; ask your eye doctor or the optical shop what your state Medicaid plan covers before you choose your frames.

Children often have more generous coverage than adults. Some state Medicaid programs cover glasses for children more than once per year or cover a wider range of frame styles and lens options for children under 18 or 21.

What to bring to your appointment

Bring your Medicaid member card and a photo ID. If your Medicaid plan requires a referral from your primary care doctor, bring that referral with you. Some eye doctors and optical shops will ask you to fill out a form confirming your Medicaid coverage before your visit.

If you have had an eye exam in the past year, ask your previous eye doctor to send your prescription to the new provider. This can speed up the process and may save you from paying for a duplicate exam if your new provider does not accept your old prescription.

If your provider does not take Medicaid

If you discover that your preferred eye doctor or optical shop does not take Medicaid, you have two options: pay out of pocket, or find a provider who does take Medicaid. Medicaid does not reimburse you after the fact, so paying out of pocket means you will not recover that money through your Medicaid plan.

Some eye doctors who do not take Medicaid may offer a cash discount if you pay at the time of service. It is worth asking, but do not count on it. Your best option is to confirm Medicaid acceptance before you schedule an appointment.

Frequently Asked Questions

Can I see any eye doctor I want with Medicaid?

No. You must see an eye doctor who is in-network with your state Medicaid program. If you see an out-of-network provider, Medicaid will not pay, and you will be responsible for the full cost. Call your Medicaid plan to confirm that your preferred doctor takes Medicaid before you schedule an appointment.

Do I need a referral to see an eye doctor on Medicaid?

It depends on your state Medicaid plan. Some plans require a referral from your primary care doctor; others do not. Call the customer service number on your Medicaid card to find out whether your plan requires a referral before you schedule an eye appointment.

Does Medicaid cover the cost of an eye exam?

Yes. Medicaid covers an eye exam as part of its vision benefit. The exam itself is covered at no cost to you when you see an in-network provider. You may have a copay depending on your state and plan, but many state Medicaid programs waive copays for preventive care like eye exams.

What if I need new glasses more than once a year?

Most state Medicaid programs cover one pair of glasses per year. If you need a new prescription before a year has passed, you will likely have to pay out of pocket. Some exceptions exist for children or for medical reasons like a significant change in vision, so ask your eye doctor or Medicaid plan whether you may be covered.

Can I use Medicaid at Costco or Walmart for glasses?

Costco Optical and Walmart Vision Center accept Medicaid in many locations, but not all. Acceptance varies by state and by individual store. Call the specific location near you or call your Medicaid plan to confirm that the store you want to visit takes Medicaid before you go.