MetroPlusHealth Medicaid Covers Your Vision and Dental Care
If you're a MetroPlusHealth Medicaid member in Brooklyn, you already have vision and dental benefits built into your plan - and you probably didn't realize it. MetroPlusHealth lists vision examinations among its Medicaid Managed Care benefits and says there is no copay for covered benefits. That means you can visit an optometrist on Avenue U and get your eyes checked using your plan. Just bring your MetroPlusHealth card, and check your plan for its exact eyewear benefit.
The coverage is straightforward, but understanding exactly what's included can save you time and money. This guide breaks down your MetroPlusHealth Medicaid vision and dental benefits, what Vision Palace Optical accepts, and how to schedule your appointment.
What MetroPlusHealth Medicaid Covers for Vision
Your MetroPlusHealth Medicaid plan can include routine eye exams, eyeglasses and, when medically necessary, contact lenses. Here's what that actually means on the ground in Brooklyn.
Eye exams are covered. MetroPlusHealth lists vision examinations among its Medicaid Managed Care benefits, and a Medicaid managed care plan must cover at least what regular New York Medicaid does, and can add to it. New York State Medicaid's Vision Care Manual sets the usual frequency for a complete eye exam at once every two years (24 months), more often when medically necessary and documented. Check your plan for its exact schedule. Your optometrist will evaluate your vision, check for eye disease, measure for glasses or contacts, and screen for conditions like glaucoma or diabetic retinopathy. At Vision Palace Optical on Avenue U, we accept MetroPlusHealth Medicaid for these exams. Coverage varies by plan - call us or book through Zocdoc to verify your benefits before your visit.
Eyeglasses are covered too. Under regular New York Medicaid, eyeglasses are usually covered once every two years, chosen from a selection of Medicaid frames, and the lens benefit covers single vision, bifocal and, when medically necessary, trifocal lenses. Upgrades such as progressive or photochromic lenses are not part of the regular Medicaid benefit. Your plan's exact eyewear benefit varies, so check your plan.
Contact lenses can be covered by regular New York Medicaid only when they are medically necessary for an eye condition. We do contact lens fittings for daily, monthly, toric, and multifocal prescriptions. Coverage varies by plan - call us or book through Zocdoc to confirm your specific limits.
The key thing to remember: MetroPlusHealth says there is no copay for covered benefits on its Medicaid Managed Care plan. You come in, we verify your coverage at check-in, and we'll tell you before anything is ordered if an item is outside your benefit.
MetroPlusHealth Dental Coverage: What's Included
Your MetroPlusHealth Medicaid plan also includes dental coverage. While you're on Avenue U getting your eyes checked, you can arrange dental care through your plan's network. According to MetroPlusHealth, dental benefits typically include preventive care like cleanings, exams, and X-rays, plus basic restorative work.
Coverage varies by plan - call MetroPlusHealth directly or ask us at your eye exam. MetroPlusHealth is common across Sheepshead Bay, Gravesend, and Brighton Beach, and having vision and dental in one plan keeps things simple.
How to Use Your MetroPlusHealth Medicaid Benefits at Vision Palace Optical
Using your MetroPlusHealth vision benefits is simple. Here's the process.
Step 1: Bring your MetroPlusHealth card. When you arrive for your eye exam, just show us your Medicaid card. We'll verify your coverage at the front desk.
Step 2: Get your eye exam. Dr. Julia Sheyko or Dr. Alexander Shlivko will perform your comprehensive eye exam. We'll check your vision, evaluate your eye health, and discuss whether you need glasses, contacts, or any other care.
Step 3: Choose your frames. After your exam, you can choose from the frames your Medicaid benefit covers. Under New York Medicaid rules, the benefit can't be applied toward a more expensive frame with you paying the difference; an upgraded frame is a separate private purchase.
Step 4: Get your glasses. We'll fit your lenses and make sure everything sits right on your face.
That's it. Prior authorization and referral rules depend on your plan, so check your plan if you're unsure.
MetroPlusHealth Plans in Brooklyn: What You Should Know
MetroPlusHealth offers multiple Medicaid managed care plans in New York, and several serve Brooklyn directly. Whether you're on a standard Medicaid plan, a plan for pregnant women, or a plan for people with disabilities, vision and dental benefits are included.
Vision benefits can differ between MetroPlusHealth products. Under regular New York Medicaid, the usual frequency is one complete eye exam and one pair of glasses every two years, more often when medically necessary, and your plan must cover at least that. Check your plan for its exact schedule. Coverage varies by plan - call us at (718) 998-8400 or verify your coverage before your visit.
One thing Brooklyn families appreciate about MetroPlusHealth: it's affordable. MetroPlusHealth says there is no copay for covered benefits on its Medicaid Managed Care plan. Check your plan for what is covered.
Why Choose Vision Palace Optical for Your MetroPlusHealth Benefits
We've been on Avenue U in Sheepshead Bay for over 30 years. We accept MetroPlusHealth Medicaid, along with Fidelis Care, 1199SEIU, Medicare, EyeMed, and most other major plans. Our optometrists, Dr. Julia Sheyko and Dr. Alexander Shlivko, speak English and Russian, and we work with patients from all over Brooklyn - from Gravesend to Marine Park to Bensonhurst.
We don't rush you. We don't upsell you. We just make sure your eyes are healthy and that you walk out with glasses you actually like wearing.
Frequently Asked Questions
Does MetroPlusHealth Medicaid cover my eye exam? Yes. MetroPlusHealth lists vision examinations as a covered Medicaid Managed Care benefit with no copay. Under regular New York Medicaid, the usual frequency is one complete eye exam every two years, more often when medically necessary, and your plan must cover at least that. Coverage varies by plan - call us or book through Zocdoc to verify your benefits before your visit.
What if I need glasses and contacts? Under regular New York Medicaid, glasses are usually covered once every two years, and contact lenses only when they are medically necessary for an eye condition. Your plan may differ, so check your plan.
Do I need to get prior authorization before my eye exam? It depends on your plan. Check with MetroPlusHealth member services, or call us and we'll help you verify. Bring your Medicaid card to your visit.
Can I get prescription sunglasses or special lenses like photochromic lenses? Photochromic and progressive lenses are not part of the regular New York Medicaid lens benefit, and prescription sunglasses depend on your plan. Ask us when you call to schedule, or we'll check during your visit.
What if I want designer frames? Under New York Medicaid rules, your benefit covers a selection of Medicaid frames and can't be applied toward a more expensive frame with you paying the difference. If you want a frame outside your benefit, you can buy it as a private purchase. Ask us to explain the options before you choose.
How often can I get new glasses with MetroPlusHealth? Under regular New York Medicaid, usually once every two years, with new lenses sooner when there is a documented medical reason such as a significant change in your prescription. Check your plan for its exact schedule.
References
- MetroPlusHealth - Medicaid Managed Care Plans. Medicaid health insurance coverage in New York.
- MetroPlusHealth - Medicaid Managed Care Details. Covered benefits, including vision examinations; no copay for covered benefits.
- New York State Medicaid Program - Vision Care Manual, Policy Guidelines. eMedNY, New York State Department of Health. Frequency limitations, eyeglass dispensing and Medicaid managed care enrollees.
- MetroPlusHealth - What Does MetroPlusHealth Dental Coverage Cover?. Dental benefits information for members.
- MetroPlusHealth - Your Questions about Health Insurance, Answered. Frequently asked questions about coverage and benefits.
Book your eye exam at Vision Palace Optical and use your MetroPlusHealth Medicaid benefits. Book through Zocdoc, get in touch, or call us at (718) 998-8400. We're at 1723 Avenue U in Brooklyn, open Monday through Saturday. We accept MetroPlusHealth Medicaid, along with Fidelis Care, 1199SEIU, Medicare, and most other major plans.