Vision Benefits of Medicaid in Michigan

Medicaid is a health insurance program funded by federal and state dollars. The Michigan Department of Community Health administers Michigan’s Medicaid programs. Medicaid is available for individuals and families with low or no income or those with certain special circumstances. Michigan integrates vision care benefits into the Medicaid medical health insurance programs in Michigan for both adults and children.

Vision care is available through many of Michigan’s Medicaid programs. Programs that integrate vision benefits with medical include MIChoice, the Low Income Families program, Special N Support, the Transitional Medical Assistance program, Healthy Kids, MIChild among others. Some of the vision care services may require co-pay at the time of your appointment, depending on the plan you enroll in. For more information about specific vision benefits, you can call the beneficiary hotline at 800- 642- 3195.

Medicaid in Michigan is available to financially needy adults and children. Individuals must qualify for any health insurance programs sponsored by the Michigan Department of Community Health. Michigan requires candidates for the Medicaid program take an income and assets test to demonstrate their financial need. Some programs may disqualify adults but cover children. Although you may be over the income limit for some Medicaid programs, the state may still assist you with health insurance coverage, depending on your need and other qualifying circumstances.

You can apply for any Medicaid program through your local county Michigan Department of Human Services office. A listing of offices is found on the Michigan Department of Community Health website. Consumer representatives at each office will walk you through the application process. You can also apply online for some Medicaid programs including MIChild, Healthy Kids, PLAN FIRST! and MOMS Prenatal services (see Resources). You can also call or email the Michigan Department of Human Services with any questions about applying for Medicaid and the benefits available.

All Michigan Medicaid plans have a provision for the Early and Periodic Screening Diagnosis and Treatment (EPSDT) Program. This program requires objective screenings for vision among other screens for hearing, development behavior and dental. The mandates states “vision services must include at least diagnosis and treatment for defective vision, including glasses if appropriate.” The contracted health plans providing Medicaid services must outreach to beneficiaries who have not taken their children for EPSDT screenings. The program will assist in making vision care and other appointment and arrange for transportation if necessary.