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PDFWAC 182-544-0325

Vision careCovered eyeglass frames and repairsClients age twenty and younger.

(1) The medicaid agency covers durable or flexible frames when the client has a diagnosed medical condition that contributes to broken eyeglass frames. To receive payment, the provider must order the "durable" or "flexible" frames through the agency's designated supplier.
(2) The agency covers all of the following for clients:
(a) Coating contract eyeglass frames to make the frames nonallergenic. Clients must have a medically diagnosed and documented allergy to the materials in the available eyeglass frames.
(b) Four incidental repairs to a client's eyeglass frames in a calendar year. To receive payment, all of the following must be met:
(i) The provider typically charges the general public for the repair or adjustment;
(ii) The contractor's one year warranty period has expired; and
(iii) The cost of the repair does not exceed the agency's cost for replacement frames and a fitting fee.
(c) Up to two replacement eyeglass frames in a calendar year when the eyeglass frames have been lost or broken. Lost or broken eyeglass frames must be documented in the client's medical record.
[Statutory Authority: RCW 41.05.021, 41.05.160. WSR 17-14-067, § 182-544-0325, filed 6/29/17, effective 7/30/17. WSR 11-14-075, recodified as § 182-544-0325, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090. WSR 11-11-016, § 388-544-0325, filed 5/9/11, effective 6/9/11. Statutory Authority: RCW 74.08.090, 74.09.510, 74.09.520. WSR 08-14-052, § 388-544-0325, filed 6/24/08, effective 7/25/08.]
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