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L.A. Care Vision Insurance: Plans, Coverage & Costs

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L.A. Care offers some fairly basic vision coverage with many of their plans, usually covering routine exams and eyewear. They don’t offer much in the way of more advanced benefits, such as elective corrective surgery coverage.

Vision Insurance Plans Offered

A person can get vision coverage through three (arguably four) plans connected to L.A. Care:

  • L.A. Care Medi-Cal 
  • L.A. Care Covered (and the very similar L.A. Care Covered Direct)
  • L.A. Care Cal MediConnect

L.A. Care’s PASC-SEIU plan does not come with any kind of routine vision services coverage. Their site says to call 1-844-854-7272 regarding this if you have questions, although it seems unlikely most vision care would be covered under this plan, even if there are occasional exceptions.

What Does It Cover?

Different plans offer different levels of coverage, although the three plans mentioned all have coverage for one routine eye exam every year, or every two years in the case of their Medi-Cal plan, and the ability to get prescription glasses covered periodically. L.A. Care Covered/L.A. Care Covered Direct and L.A. Care Cal MediConnect can also cover contact lenses, but Medi-Cal members can only get contact lens coverage if they are medically necessary in a way that eyeglasses cannot be.

The L.A. Care Cal MediConnect Plan seems to offer the best coverage, mentioning coverage for outpatient doctor services for diagnosis and treatment of eye diseases and injuries. Certain recommended testing, such as glaucoma screenings for those at high risk, is also covered. 

Details about their Medi-Cal plan also note more frequent eye exams will be covered in addition to coverage for a routine exam every 24 months if those exams are considered medically necessary, such as if a person is at increased risk for eye disease.

LASIK & Refractive Surgery Coverage

Unfortunately, L.A. Care makes no mention of LASIK or refractive surgery coverage on their site. These procedures are generally considered elective, meaning they aren’t medically necessary due to alternative (often cheaper) options existing that can provide the same level of correction (such as glasses). 

Costs

Routine eye exams seem to cost nothing under these plans, with additional eye exams that are considered medically necessary also generally fully covered. Eyeglasses also seem to be covered if they are a reasonable price (under $200 for frames and lenses), and the plans that cover contact lenses allow for similar coverage. 

The Medi-Cal plan makes mention of covering other and potentially more expensive low-vision devices if those devices provide correction standard glasses, lenses, medicine, or surgery can’t provide. They also mention they will cover eyeglasses that are lost or damaged if that loss or damage wasn’t the fault of the member.

You can read about other care costs unrelated to vision here. One of L.A. Care’s more interesting offerings is the ability to talk to a licensed nurse 24/7 for free with all their plans.

Eligibility

For their Covered brand of plans, you can check your eligibility using L.A. Care’s plan shopping tool. For their Medi-Cal option, you can check whether you qualify using this page that explains the criteria.

Cal MediConnect is intended for those who qualify for both Medicare and Medi-Cal. You can read more about it on L.A. Care’s site, or you can call 1-855-522-8243. This is a number listed for prospective members of this program to talk with a representative and get more information.

References

  1. L.A. Care Vision. L.A. Care Health Plan.
  2. Know Your Care Options. L.A. Care Health Plan.
  3. Shop Plans. L.A. Care Health Plan.
  4. Medi-Cal: Do I Qualify? L.A. Care Health Plan.
  5. Cal MediConnect. L.A. Care Health Plan.

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