Medicaid routine vision benefits to be administered by EyeMed beginning Dec. 1, 2022

9/26/2022

Effective Dec. 1, 2022, we’re making a change to our Medicaid vision benefits and network for all Medicaid products, including Medicaid, Children’s Special Healthcare Services (CSHCS) and the Healthy Michigan Plan (HMP).

We have partnered with EyeMed to administer routine vision services as an embedded benefit for all Priority Health Medicaid members. Beginning Dec. 1, 2022, members will have an embedded routine vision benefit which includes:

  • Eye Exam: One exam every 2 years for members of all ages
  • Glasses: One pair every 2 years for members of all ages
  • Repairs and replacements: 2 pair per year for members under 21; 1 pair per year for members 21 and over
  • Contacts: Medically necessary only for all ages (no PA required)

Members must see a provider within the Priority Health Medicaid EyeMed network to use this benefit. We will not pay or reimburse claims for these services if rendered by providers who are not in the Priority Health Medicaid EyeMed network.

If you’re a Priority Health Medicaid vision provider without an existing relationship with EyeMed

Beginning Dec. 1, 2022 EyeMed will begin administering the routine vision network on behalf of Priority Health. Many of these members already in your care. We’re inviting you to join the EyeMed network to provide routine vision services to these members. You do not need to participate with any other EyeMed network to take advantage of this opportunity.

You should have received outreach from an EyeMed recruiter with information about joining the network. If you would like to get in touch with EyeMed directly, visit EyeMed.

If you’d like to participate with the EyeMed Medicaid network, EyeMed will send you a provider agreement and fee schedule. They’ll also help you get set up with a frame collection and sign up with Classic Optical for lab orders.

If you’re already contracted within the EyeMed network

Great! You’ll automatically be included in the Priority Health Medicaid network. Look for additional outreach from EyeMed with additional instructions to receive a frame collection and sign up with Classic Optical to service the lab orders.

Questions? Get in touch with EyeMed through their Contact Us page.