Optical Services

HOW TO ACCESS:

Optometrist, Opthamologist or Optical Supplier

ELIGIBILITY:

All Medicaid recipients.

COVERED SERVICES:

Recipients 0 through 20
Examinations and treatment of eye conditions, including examinations for vision correction, refraction error.

Regular eyeglasses when they meet a certain minimum strength requirement.  Medically necessary specialty eyewear and contact lenses with prior authorization.  Contact lenses are covered if they are the only means for restoring vision.

Other related services, if medically necessary.

Recipients 21 and over
Examinations and treatment of eye conditions, such as infections, cataracts, etc.

If the recipient has both Medicare and Medicaid, some vision related services may be covered.  The recipient should contact Medicare for more information since Medicare would be the primary payer.

COMMENTS:

Recipients 0 to 21
Specialty eyewear and contact lenses, if medically necessary for EPSDT eligibles requires Prior Authorization.  The provider will submit requests for the Prior Authorization.  A prior authorization approval does not guarantee patient eligibility.

Prescriptions are required for all glasses/contacts. After a prescription is obtained, the recipient may see an optical supplier to receive the glasses/contacts.

Recipients 21 and over
NON-COVERED SERVICES:

  • Routine eye examinations for vision correction
  • Routine eye examinations for refraction error
  • Eyeglasses

** Please Note: The contact person and number provided should not be utilized for making appointments. Members that are enrolled with one of the Healthy Louisiana plans should contact Healthy Louisiana via the information below:

https://www.myplan.healthy.la.gov/en

Phone

Monday through Friday from 8:00 a.m. to 5:00 p.m. Call 1-855-229-6848.

For hearing impaired (TTY) please call

1-855-526-3346.

Mail

Healthy Louisiana

P.O. Box 1097

Atlanta, GA 30301-9913

Fax

1-888-858-3875


CONTACT:

Ophthalmology:

Crystal Faison

225/342-8233

 

Eyewear:

Irma Gauthier

225/342-5691