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    A pediatrician examining a baby’s eyesight.

    Do Babies Need Vision Insurance?

    5 mins

    As a parent, your first and strongest instinct is to protect your children. You work hard to put them in the best schools, make sure they hang out with the right crowd, and avoid unnecessary risks.

    When you think about the future you’re building for your kids, you probably picture them happy and healthy. But sometimes, the best way to do that isn’t clear.

    When it comes to visual health, some parents wonder, “Do babies need vision insurance?” While the answer might sound like an obvious “yes,” like most things in life, the answer is a little more complicated.

    Private Medical Insurance

    Let’s start when your baby is born (or after you adopt). During this time frame, you usually have thirty to sixty days to add your bundle of joy onto your health insurance if you have a policy in place (if you don’t, we’ll discuss your options later in just a bit!).

    If you and your spouse have separate insurance policies, you’ll have to decide which policy will cover your infant. Usually, making changes to your insurance plan requires waiting for a certain window of opportunity, but having or adopting a baby is considered to be a “qualifying life event.” This means you can make alterations to your health plan right away.

    Employer-Based Medical Insurance

    If you have insurance through your workplace, your new baby can easily be covered, but you will have to notify your employer within thirty days of birth or adoption that you want to add your child to your plan.

    Coverage will extend back to your baby’s birthdate, so any procedures or tests performed before you officially add them to your insurance should be covered retroactively.

    Some companies offer more than thirty days for parents to sign up, so you’ll have to check with your employer on the time limits that apply to your coverage.

    Eyeglasses displayed on a shelf
    dusanpetkovic via Getty Images

    When You Don’t Have Vision Insurance

    If you’re uninsured, you may be eligible for Medicaid. Depending on which state you live in, Medicaid can cover most or even all your medical costs. For your new baby, you can get coverage through the Children’s Health Insurance Program (CHIP), which covers vision care, as well as dental, emergency care, vaccinations, and pediatric visits.

    If you have care through the Affordable Care Act (ACA), your children will be covered automatically. Through the ACA, children up to age 19 can receive free eye exams every year.

    Coverage through Medicaid, CHIP, and the ACA is intended for low-income earners, so you may not be eligible if your wages are too high.

    If you’ve recently lost your job, the Consolidated Omnibus Budget Reconciliation Act (COBRA) allows you to purchase your employer’s health insurance for 18 months after your termination. It’s comparatively expensive, but it can help you to get by until you find work again.

    Another option is IntantSEE, a publicly funded vision care program that is specifically designed for children between 6 and 12 months of age. It’s managed by Optometry Cares and the AOA Foundation. Participating optometrists provide free eye exams to families of any income level.

    Visits to Your Pediatrician

    Unless you have a family history of vision problems or a specific reason to test your baby’s vision, most pediatricians start testing within 12 months of age.

    If any concerns arise during these appointments, your pediatrician can refer you to a pediatric ophthalmologist rather than an optometrist. The benefit is that an ophthalmologist uses standard medical insurance rather than vision insurance.

    To test your baby’s vision, your pediatrician will most likely use an ocular photoscreen. This checks for issues such as:

    • Red reflex

    • Eye alignment

    • Myopia

    • Astigmatism

    • Gaze deviation or asymmetry

     Since your pediatrician can perform this test, it will be covered under any major private medical insurance plans, as well as Medicaid.

    Observation at Home

    When children are born, they’re not able to focus on objects that are more than eight to ten inches from their faces. By about eight weeks of age, they should be able to focus on a parent’s face.

    During this season, you may notice that your child’s eyes seem like they cross and move from object to object, wandering around. This is normal!

    However, if one of their eyes tends to move in or out while the other is stationary, it could indicate an eye problem.

    By month five, depth perception and color vision develop. From five to eight months, hand-eye coordination will strengthen as crawling begins.

    By twelve months of age, your child will begin walking and be able to judge distances well. As they move past one year, object recognition will get stronger. Observing your baby’s vision milestones can help you determine whether there’s an issue you’ll need to get checked out by a doctor.

    What’s the Verdict?

    So does your baby need vision insurance? Depending on the insurance you have, they may be covered already.

    Should you get them separate or supplemental vision insurance? That depends on their vision health. If there’s a concern for pre-existing conditions or your pediatrician discovers an abnormality that requires attention, then you probably should talk to your insurer about your options.

    There are many ways you can assess your child’s vision, so no matter what you decide about coverage, it’s up to you to care for your children and give them a healthy start for the future!

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    Kristina Dinabourgski
    Has a passion for demystifying benefits 🎉
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