By Jorge Ruiz, Assistive Technology Coordinator at the Central Coast Center for Independent Living in Salinas
As an assistive technology advocate, I often get requests from consumers on a variety of different pieces of equipment and services. Recently many of our consumers have inquired about funding assistance for basic eye glasses. Of course, before acquiring glasses one must first acquire a prescription from an eye doctor in order to have glasses made. This is the first barrier as many of our consumers don’t have vision coverage or don’t have the resources to pay for those services. Furthermore consumers often believe that Medi-Cal can pay for those services. Here is what Medi-Cal’s vision care policy from their website:
As of July 26, 2010 Medi-Cal again started covering an eye exam from an eye doctor for beneficiaries 21 years or older.
What will Medi-Cal now pay for?
Medi-Cal will now pay for these services if you are any age:
· To see an eye doctor to test your eyes
· To test for a prescription for eyeglasses
· To test for a prescription for contact lenses if you have eye diseases
· To check the health of your eyes
· To check to see if you have low vision
What vision-related expenses will Medi-Cal NOT pay for?
Medi-Cal will not pay for these if you are 21 years of age or older (except in some cases):
· New eyeglasses or to fix your glasses
· Contact lenses
· Things that will help you see better (like magnifying glasses)
What are the exceptions?
Medi-Cal will pay for eyeglasses, contact lenses or other things to help you see better for only these people:
· Pregnant women; and only if your doctor says that not having them will be harmful to your baby or pregnancy
· Children or people less than 21-years-old who have full Medi-Cal
· People who live in a nursing home
There you have it. Unless you fit in that small population, you won’t be able to get glasses through Medi-Cal.
As an advocate, my next step is to brainstorm solutions that fill this gap when consumers don’t have the proper coverage to acquire glasses. The first places I look are service organizations like the Lions Club, an organization that recycles eyeglasses throughout the world. Our local Lions Club assisted my consumers in acquiring much needed services. But what can we do when there are no Lions Clubs available to help?
Recently I found out about the organization called New Eyes for the Needy that helps with the cost of prescription glasses for low income individuals in the United States. The applicant submits an application along with a copy of a recent prescription for eyeglasses and, if approved, the applicant receives a voucher from the organization for the cost of glasses. The applicant will then have to find a dispenser that will agree to make glasses for the consumer at the rates printed on the voucher. Once the glasses are made, the organization will reimburse the dispensary for the work completed. The hard part of the program is finding a dispensary that takes the voucher, but once you do, the process is much smoother. Furthermore, the organization is partnering with Wal-Mart vision Center and many Walt-Marts have started taking the voucher.
We often have to think outside of the box to find resources that meet our needs or the needs of the people we serve.
Have you found any new funding sources that fill the gaps that insurance coverage doesn't provide?