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What Parents Should Know About The Pediatric Optometric Care Benefit

Affordable Care Act Includes Eye Exams for 19 and Under

By Dr. Darren Wright, President, Nebraska Optometric Association

Wright2As part of the Affordable Care Act (ACA), that took effect Jan. 1, 2014, children in Nebraska and across the country will benefit from better eye care. Optometric eye health and vision care for children has been deemed essential and will be included in new health insurance coverage.

This new requirement recognizes that regular comprehensive eye exams during childhood are critical to ensuring visual health and readiness for school. Parents can now directly access eye care for their children under age 19 through their local doctor of optometry. This new requirement recognizes that regular comprehensive eye exams during childhood are critical to ensuring visual health and readiness for school.

Unlike limited stand-alone plans that can be offered as add-ons to coverage but are not required, the new pediatric eye care essential health benefit will be included as a core benefit and embedded within the overall health plan. This approach provides the seamless primary eye health and vision care children need.

While most childhood vision problems can be prevented through early detection, follow-up and treatment, millions of children are not receiving comprehensive eye examinations necessary for early detection of the most significant vision problems. The limited screenings, which many children receive at school or at their pediatricians’ office, check only for far vision difficulties and are not a substitute for a comprehensive eye examination performed by your local Doctor of Optometry.

Although it is important that children see the whiteboard, it is equally important that their eyes are healthy and that their vision is clear. And, maintaining focus and eye alignment is critical to reading comprehension. A comprehensive eye examination can help prevent school and social achievement problems by detecting near eye focusing and alignment difficulties, eye diseases, life-threatening conditions, and developmental delays with the highest level of accuracy.

Early and annual comprehensive eye examinations contribute to healthy development and a child’s success in school and later in life. For the first time, the federal government is recognizing eye health care from birth through age 18 as essential and is linking both medical eye care and vision care together under the same plan.

Additional Resources

Locate a Doctor of Optometry in your area

More information about this topic from the American Optometric Association

Children’s Eye and Vision Care Fact Sheet from National Commission on Vision and Health

Nebraska Foundation for Children’s Vision