Vision Care

Handbook Content

Terms and Meanings

Some terms that we use in this chapter may not be familiar. These terms and their meanings are listed below.

  • Optician: An eye care specialist who helps you choose the right glasses, lenses, or other vision devices.
  • Optometrist: A specialist who takes care of the primary health of your eyes.
  • Ophthalmologist: A doctor who specializes in eye care, treats complex eye disorders, and performs surgery.
  • Primary Care Provider: Your main health care professional who maintains your good health and cares for your basic health needs by giving vaccines, finding disease, and offering medication or treatment for conditions or symptoms.
  • Provider: A doctor, nurse, therapist, or another qualified health care professional.
  • Services: Care, treatments, testing, checkups, equipment, supplies, and other ways your health care providers help you stay healthy.
  • TTY: The number you can call to connect with someone when you have a hearing impairment

Medicaid helps pay for vision care so you can keep your eyes healthy, check your vision, and correct your vision when needed. Your optician, optometrist, or ophthalmologist can offer:

  • Eye exams and vision tests
    • Members 20 years old and younger : Every year
    • Members 21 years old and older: Every two years
  • Eyeglasses and frames
    • Members 20 years old and younger: Every year
    • Members  21 years old and older: Every two years
  • Lens options and add-ons 
    • Blue blocking (must be medically needed)
    • Contact lenses (must be medically needed, as described below)
    • Other tint options (must be medically needed)
    • Photochromatic (must be medically needed)
    • Polycarbonate lenses (single vision, bifocal, or trifocal)
    • Rose tints
    • Slab-off and Fresnel prism (must be medically needed)
    • Ultraviolet (must be medically needed)

Your eye care provider can help you select lenses and frames that will be covered. You can choose to keep your frames and only get new lenses when you are eligible for a new set. 

Dispensing fees and the cost for lenses and/or frames are not covered if they are ordered sooner than the time limits based on your age. If you need repair, refitting, or services more often than or beyond the services listed above, your provider will need to ask for approval from Medicaid. 

Members with certain medical conditions may need more frequent appointments. If you need more appointments than allowed per year, your provider will need to ask for approval from Medicaid. 

Medicaid only covers contacts for members with one of the following specific medical conditions:

  • Keratoconus
  • Sight that cannot be corrected to 20/40 with eyeglasses
  • Aphakia
  • Anisometropia of 2 diopters or more.   

For a list of Medicaid enrolled providers, you can: 

  • Contact your primary care provider
  • See our list of Non-Primary Care Providers 
  • Call our Customer Support Center

Contact Information Mentioned in this Chapter

  • Customer Support Center
    • Toll-Free: 1-866-614-6005
    • Local: 1-701-328-1000
    • TTY: 711
    • Free translation available upon request
    • Email: applyforhelp@nd.gov 
    • Mail: Customer Support Call Center 
      PO Box 5562 
      Bismarck, ND 58506
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