Sec. 10.67.06.14. Benefits — Vision Care Services

A. An MCO shall provide to its enrollees medically necessary vision care services as specified in this regulation.

B. For enrollees who are 21 years old or older, the MCO is responsible for providing at least one eye examination every 2 years.

C. For its enrollees who are younger than 21 years old, the MCO is responsible for providing medically necessary vision services, including but not limited to:

(1) At least one eye examination every year in addition to any vision screen performed as part of an EPSDT screen;

(2) Eyeglasses, limited to one pair per year unless lost, stolen, broken, or no longer vision appropriate; and

(3) Contact lenses, if medically necessary and if eyeglasses are not efficacious for the condition.