How to get free or low-cost eye exams and glasses

Children enrolled in Medicaid and CHIP are entitled to vision screening, eye exams and glasses as part of their benefits. Many schools run vision screening, and some partner with nonprofit programmes that provide free glasses directly at school.

Adult vision coverage under Medicaid is optional, so it varies. Some states cover routine exams and glasses; others only medically necessary eye care. Eye disease - glaucoma, diabetic eye disease, cataracts - is generally covered as medical care by Medicaid, Medicare and private insurance even when routine glasses are not.

Original Medicare does not pay for routine eye exams or glasses, but covers some eye care such as cataract surgery, after which it helps pay for one pair of glasses. Many Medicare Advantage plans add routine vision benefits.

Charitable programmes fill gaps. Lions Clubs have long provided eye exams and recycled or new glasses, and national eye care charities offer free exams and glasses for people with low income, seniors, or children. Some optometry schools offer low-cost clinics.

Community health centres increasingly offer optometry, charging on the sliding scale.

It helps to separate two kinds of eye care. Routine vision care - an eye exam to check your prescription and a pair of glasses or contact lenses - is often excluded from regular health insurance and from Original Medicare. Medical eye care - diagnosing and treating eye diseases and injuries such as glaucoma, cataracts, diabetic retinopathy, macular degeneration, infections or a scratched cornea - is covered by health insurance, Medicaid and Medicare like any other medical care. If you have symptoms such as sudden vision changes, eye pain, flashes or floaters, that is a medical visit, not a routine one.

For children, vision problems can look like learning or behaviour problems. A child who cannot see the board may struggle to read or seem inattentive. Medicaid and CHIP cover eye exams and glasses for children, and many schools run screening and partner with nonprofits that provide free exams and glasses on site, sometimes delivered within weeks. If your child fails a school screening, follow up with a full eye exam.

When buying glasses with no coverage, prices vary widely. Online retailers and big-box stores often sell basic single-vision glasses at a fraction of boutique prices, and you are entitled to a copy of your prescription after an eye exam under federal rules, so you can buy glasses wherever you choose. Ask the exam provider for your pupillary distance measurement too if you plan to order online.

Charity programmes have their own eligibility rules, often income-based.

1. Check your coverage

   Medicaid, CHIP, Medicare Advantage or VA.

2. Ask the school

   For children, about screening and free-glasses programmes.

3. Contact charities

   Lions Clubs and eye care charities; call 211.

4. Find a health centre with optometry

   Sliding fees.

5. Ask optometry schools

   Low-cost clinics.

6. Shop around for glasses

   Prices vary widely.

Routine vision care

An eye exam to check your prescription and the glasses or contacts that correct it, often not covered by regular insurance.

Medical eye care

Diagnosis and treatment of eye diseases or injuries, covered as medical care by health insurance, Medicaid and Medicare.

Optometrist

An eye doctor who performs eye exams, prescribes glasses and contacts, and treats some eye conditions.

Ophthalmologist

A medical doctor specialising in eye disease and surgery.

Pupillary distance (PD)

The distance between your pupils, needed to make glasses correctly, especially when ordering online.

Eyeglass Rule

A federal rule requiring eye doctors to give you a copy of your glasses prescription after an exam.

• InsureKidsNow - CHIP and Medicaid for childrenwww.insurekidsnow.gov
• HRSA - find a health centrefindahealthcenter.hrsa.gov