MedicaidCoverageMedium impact
Chapter O-200, Handbook for Providers of Optometric Services Eyeglasses Limitation for Adults 21 Years of Age and Older
Illinois Medicaid - HFS·IL · Optometry, Ophthalmology·Provider Notice
Effective date
Jul 1, 2012
We identified it
Jun 20, 2026
Summary
Illinois Medicaid has limited eyeglasses benefits for adults 21 years and older to once every two years, effective July 1, 2012. This affects billing frequency for optometric services and eyeglasses coverage for adult Medicaid patients.
Action Required
Immediately: Billing team must update patient eligibility verification to check last eyeglasses claim date for Illinois Medicaid patients 21+ years old. Implement system alerts to prevent billing eyeglasses services more than once per two-year period. Update front desk staff to inform patients of the two-year limitation during scheduling.