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Exchange Ponders Adult Vision Benefit

Vision benefits for adults will be on the table at Thursday’s meeting of the Covered California board of directors.

The board will hear the choices for expanding coverage to include vision for adults enrolled in plans through Covered California. Children up to age 18 receive those benefits now, according to Roy Kennedy, public information officer at Covered California.

“We have no adult vision right now. The board will hear a proposed vision plan solution, what it might look like going forward,” Kennedy said.

There are two big sticking points to adding vision coverage, Kennedy said:

  • It’s not listed as one of the 10 essential health benefits, so those plans that utilize tax subsidies are not eligible for vision coverage; and
  • The exchange can’t be used to manage non-qualified health plan programs, “which is what this would be,” Kennedy said.

Colorado is the only state exchange to offer vision coverage. The fiscal framework in Colorado will be one of the options presented at Thursday’s meeting, Kennedy said.

“Part of what will be discussed is how Colorado does it,” he said. “The background will include a way to do it, and one of those options is how Colorado is utilizing their exchange.”

Staff also will propose a timeline along with the vision-benefit proposal, so it can be available for those in the next open enrollment period in the fall. The benefit itself would start in January 2016.

“We’ve been working with stakeholders and with the plans, and something we’re here to do is benefit consumers,” Kennedy said. “If we can bring vision [coverage] to consumers, we’d like to do that.”

No vote will be taken on vision benefits on Thursday; it’s a discussion item.

“Then staff will try to find ways to make it happen,” Kennedy said.

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