Key Takeaways
- America's Best accepts Medicaid at many locations, but you must call ahead to confirm your state's Medicaid plan is accepted at the store where you want to go.
- Medicaid covers eye exams and glasses or contacts in most states, but the dollar amount and which frames or lenses are covered depends on your state's specific rules.
- You will need to bring your Medicaid card and photo ID to your appointment, and some stores may ask for additional documentation from your state program.
- If your local America's Best does not take your Medicaid plan, your state Medicaid program can direct you to in-network eye care providers in your area.
How to learn about Your America's Best Location Takes Your Medicaid
Call the America's Best store directly before scheduling. The store's phone number is on the America's Best website or in your Medicaid plan materials. When you call, have your Medicaid card ready and tell them which state program you're on — for example, "I'm on California Medicaid" or "I'm on New York Medicaid." Ask specifically whether they accept your plan and what services are covered.
Do not assume that because one America's Best location takes your Medicaid, another one will. Acceptance can differ by location, especially in states where Medicaid is run through managed care plans rather than directly by the state. Some stores may accept one Medicaid managed care plan but not another.
If the store tells you they do not take your plan, ask them for a referral to an in-network provider, or contact your Medicaid plan directly. Your plan's member services line (on the back of your card) can give you a list of eye doctors and optical shops in your area that do accept your coverage.
What Medicaid Typically Covers for Eye Care
Most state Medicaid programs cover an eye exam once per year or once every two years, depending on the state. The exam itself is usually covered at no cost to you. Many programs also cover eyeglasses or contact lenses, though the coverage amount varies — some states cover a full pair of glasses, while others cover only a set dollar amount (for example, $150 toward frames and lenses combined).
Coverage rules differ by state. Some states cover both glasses and contacts; others cover only one or the other. Some programs limit how often you can get new glasses — for instance, once per year or once every two years. A few states cover bifocals or progressive lenses, while others do not. When you call America's Best, ask what your state's Medicaid program covers so you know what to expect before your appointment.
Children's Medicaid coverage is often more generous than adult coverage. Many states cover eye exams and glasses for children more frequently or with higher dollar limits. If you're calling about a child's appointment, mention that when you ask about coverage.
What to Bring to Your Appointment
Bring your Medicaid card and a photo ID. Some America's Best locations may also ask for your Social Security number or other information from your Medicaid enrollment paperwork. If you're unsure what to bring, ask when you call to schedule.
If you have a managed care Medicaid plan (rather than traditional Medicaid), you may also need to bring your managed care plan card. Some stores ask for both. Having both cards with you prevents delays at check-in.
If America's Best Does Not Take Your Medicaid Plan
Not every America's Best location accepts every Medicaid plan. If your local store does not take your coverage, you have several options. Call your Medicaid plan's member services line (the number is on your card) and ask for a list of in-network eye doctors and optical shops near you. Your state Medicaid program's website also usually has a provider search tool where you can enter your zip code and see which eye care providers accept your plan.
Some people travel to a different America's Best location if one nearby does not take their plan, but that is not necessary — your state has other providers who accept Medicaid. Your plan's member services team can tell you which options are closest to you and whether any have shorter wait times for appointments.
Understanding Copays and Out-of-Pocket Costs
Many Medicaid programs cover eye exams and glasses with no copay, meaning you pay nothing at the appointment. However, some state programs charge a small copay (usually $1 to $5) for an exam or for glasses. A few programs require you to pay a portion of the cost if you choose frames or lenses that cost more than what the program covers.
When you call America's Best to confirm they take your plan, ask whether there is a copay for the exam and whether there is a copay or additional cost for glasses. This way you will know exactly what to expect when you arrive. If your plan covers a certain dollar amount for frames and lenses and you want something more expensive, the store can tell you what the additional cost would be.
Medicaid Managed Care Plans and America's Best
If you are enrolled in a Medicaid managed care plan (sometimes called an HMO or PPO), your plan may have a specific list of in-network providers. America's Best may be in-network for some managed care plans in your state but not others. This is why calling ahead is essential — the store needs to know which specific managed care plan you're on, not just that you have Medicaid.
Your managed care plan card will have a member services number. You can call that number and ask whether America's Best locations near you are in-network. The plan can also tell you which eye doctors and optical shops are in-network if America's Best is not an option for you.
Frequently Asked Questions
Do I need a referral from my doctor to see an eye doctor through Medicaid?
Most Medicaid programs do not require a referral to see an eye doctor or optometrist. However, some managed care plans do. When you call America's Best or your Medicaid plan, ask whether a referral is needed. If one is required, your primary care doctor can usually provide it quickly.
Will Medicaid cover contacts instead of glasses?
Some state Medicaid programs cover contacts, while others cover only glasses. A few cover both but require you to choose one per year. Call your Medicaid plan or ask America's Best when you schedule your appointment. If your state does not cover contacts, you can still buy them out of pocket.
What if I need glasses urgently and my appointment is weeks away?
Call America's Best and ask about same-day or next-day appointments. Many locations can fit you in sooner for urgent needs. If no appointment is available, ask for a referral to another in-network provider who may have faster availability. Your Medicaid plan's member services line can also help you find urgent eye care options.
Can I use my Medicaid to buy sunglasses or blue light glasses at America's Best?
Medicaid typically covers prescription eyeglasses or contacts for vision correction only. Sunglasses and specialty lenses like blue light glasses are usually not covered, even if they have a prescription. You can purchase these out of pocket if you want them.
What happens if I move to a different state?
Your Medicaid coverage changes when you move. You will need to enroll in your new state's Medicaid program, and coverage rules for eye care may be different. Once you are enrolled in your new state's program, call America's Best in your new location to confirm they accept that state's Medicaid and what is covered.