The Affordable Care Act - Vision Care For Children

Get a comprehensive eye exam for your children with a residency trained pediatric optometrist at Artisan Optics in Boise Idaho


The Affordable Care Act brought about changes in health care coverage beginning in 2010; and on January 1, 2014 even more changes rolled out across America. Those changes included pediatric vision care, with requirements to include access to an annual, dilated eye exam and glasses or contact lenses for all children under the age of 19.  

Children's eye exams with a residency trained pediatric optometrist in Boise Idaho will help them see their best.


The Affordable Care Act is one of the largest programs we've seen in decades; and even today, years later, remains underutilized by the very Americans who need it the most...children. As health care providers we have a responsibility to help educate parents about the Essential Health Benefits available for children.


Initially, The Affordable Care Act provided coverage only for childrens' vision screenings during well-child visits. Vision screenings are a quick, simple, superficial check of a child's vision; and routinely used by pediatricians, primary care physicians, nurses, and schools. In the first phase of The Affordable Care Act, if a child failed the vision screening they would then be referred for a professional eye examination with an eye doctor. Two major concerns, and points of discussion, resulted from this approach to pediatric vision care:

  • Vision screenings are not a substitute for a comprehensive, dilated eye examination with an eye doctor; nor do vision screenings provide the same diagnostic capabilities or reliability as do professional eye exams with an eye doctor.

  • Families were denied direct access to pediatric vision care.


As a result, The Affordable Care Act provisions were changed to give families direct access to pediatric vision care; and to include benefits for an annual, dilated eye exam and glasses or contact lenses for children under the age of 19.


Currently, all insurance plans (including Medicaid) meeting the minimal essential coverage mandates under The Affordable Care Act are required to include pediatric vision coverage. There are still many parents who are unaware that their children have vision coverage. Often times because the medical plans that must be purchased under The Affordable Care Act include pediatric vision services. Whereas adult vision care coverage must be purchased separately.


Pediatric vision care has been designated as an Essential Health Benefit under The Affordable Care Act provisions. The goal is to improve the state of pediatric vision care here in the United States; and increase direct access to eye doctors for comprehensive eye examinations. An important step when you consider that:

  • Vision screenings miss up to 32% of the most prevalent pediatric vision disorders. That is 1 in 3 children who have a common childhood vision problem.

  • Children who have vision screenings are 73% less likely to be seen for a professional eye examination by an eye doctor.

  • More children receive a vision screening than receive a comprehensive eye examination before kindergarten.

  • Only 14% of all U.S. children have had an eye examination by age 6.

  • Only 51% of all U.S. school-aged children ages six to 16 have had a comprehensive eye examination.

  • Children from lower income households (at or below 400 percent of Federal Poverty Level) are 3 times more likely to have permanent vision problems.


Research shows that children, ranging in ages six to sixteen, with Individualized Education Plans (IEPs) have high rates of undiagnosed vision problems. The research concludes that all students being considered for an IEP should have a comprehensive eye examination. Encouraging parents to take advantage of the pediatric vision care provision is an easy, no cost means to elevate the level of pediatric health care and address common childhood vision problems.


Both the American Association of Optometry (AAO) and the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) recommend a child's vision be checked at:

  • 6 months of age

  • 3 to 3 ½ years of age

  • 5 years of age (school-age)

  • every 1 to 2 years thereafter (sooner if not reading at grade level)


Fortunately for parents, direct access to a pediatric eye doctor for an annual, dilated eye exam, glasses and contact lenses is a covered provision. Parents can choose to take their child to see either a general optometrist or ophthalmologist – or parents can choose to take their child to see a pediatric optometrist or ophthalmologist. Whether parents take their children to a trained pediatric eye doctor versus an eye doctor who has had no formal training in pediatrics – there is no difference in benefit coverage for an annual, dilated eye exam. Thanks to The Affordable Care Act cost is no longer a barrier to better care. There is no reason to settle for less than the best when it comes to pediatric vision care.


A trained pediatric optometrist is an optometrist who has completed an accredited residency program in pediatrics. An optometrist such as Jill A. Kronberg, OD, FAAO. Parents should be aware that residency trained pediatric optometrists and pediatric ophthalmologists are specifically trained in the diseases and vision conditions occurring in the pediatric population. Trained pediatric eye doctors routinely use cycloplegic dilating drops (the Gold Standard of Care for pediatric patients) to assess and diagnose:

  • Amblyopia

  • Strabismus

  • Ocular pathology

  • Acuity (both distance and near)

  • Focusing skills

  • Eye tracking and fixation skills

  • Binocular vision (fusion)

  • Stereopis (depth perception)

  • Convergence and eye teaming

  • Color vision


The Affordable Care Act has brought about important changes to pediatric health care; with Essential Health Benefits mandated to improve access to care. The inclusion of no-cost pediatric vision care is an important provision, and instrumental in expanding access for all families regardless of income. It is difficult to understand why many parents fail to take advantage of this coverage – free vision care for their children. Is it awareness of the benefit? Do parents assume a vision screening is “enough”? Do parents think they would somehow “know” if their child had a vision problem? The barrier to pediatric vision care is no longer cost. Thanks to The Affordable Care Act pediatric vision care is a covered benefit.


Perhaps the architects of The Affordable Care Act assumed that by including free pediatric vision care as an Essential Health Benefit, more American children would receive professional eye examinations. Unfortunately, statistics show that access to free pediatric vision care has yet to improve the state of pediatric vision care here in the U.S. We hope that changes.  


Children's eye exams can help diagnose potential learning deficits before they enter school. At Artisan Optics in Boise Idaho

Posted by Artisan Optics at 8/31/2016 10:04:00 PM
Share |
Comments (0)
No comments yet, login to post a comment.
Current Weblogs
There are no blogs in this Group.