MedicaidPrior AuthMedium impact
Chapter O-200, Handbook for Providers of Optometric Services Additional Pair of Adult Eyeglasses Following Eye Surgery Correction to Lens Type Available through IDOC
Illinois Medicaid - HFS·IL · Optometry, Ophthalmology·Provider Notice
Effective date
Aug 18, 2017
We identified it
Jun 20, 2026
Summary
Illinois Medicaid now covers an additional pair of eyeglasses for adults 21+ within a two-year period following eye surgery (like cataract surgery) that necessitates new prescription lenses, effective for prescriptions dated August 18, 2017 or later. Prior authorization is required per Topic O-211.1, and photogray glass lenses are no longer available through the Illinois Department of Corrections eyeglasses laboratory.
Action Required
Immediately: Billing team must obtain prior authorization per Topic O-211.1 before submitting claims for additional eyeglasses following eye surgery for Illinois Medicaid patients age 21+. Update encounter forms to remind providers that photogray glass lenses are not available through IDOC. For MCO-enrolled members, submit prior auth requests directly to the appropriate MCO rather than state Medicaid.