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Childrens' Health; Underserved Populations; Vision Care; Quality Improvement


Vision services are generally classified as optional benefits in Medicaid and SCHIP, and access to vision care services may vary due to lack of uniform coverage and benefit design across states. Although children enrolled in Medicaid are generally able to obtain access to vision care services through the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) benefit, states that operate separate SCHIP programs are not mandated to cover EPSDT benefits. A GAO report found that states tend to place more limits on vision benefits in SCHIP than in Medicaid and in ten states limit the number of exams and corrective lenses covered during a year. Because of varying screening requirements, approximately two out of three children are not screened prior to enrollment. Limited access could prevent children from low-income families from obtaining proper diagnosis and treatment for vision problems.


This publication was prepared under a contract with the George Washington University's Geiger Gibson Program in Community Health Policy, School of Public Health and Health Services.

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