Humana Healthy Horizons

 

Value-added benefits (VAB)

There is no VAB for Humana Healthy Horizons^® in Ohio Medicaid members.

 

Materials

Lenses

Medicaid considers standard lenses to be CR-39 plastic single vision with scratch-resistant coating or glass.

• Polycarbonate lenses are covered for all beneficiaries.
• Tints are covered only when medically necessary for conditions such as photophobia or albinism.
• Any other lens types and options are covered only when medically necessary.

Refer to the EyeMed Ohio Medicaid Provider Manual for full details. You must be logged into your account on inFocus to access the manual.

Contact lenses

You’ll file medically necessary contact lens claims on paper using the EyeMed Ohio Medicaid claim form.

Contact lenses are covered only when the patient has an eye disease or prescription that must be managed with contacts because eyeglasses cannot provide sufficient correction. The following Ohio Medicaid qualifying criteria will apply:

• Aphakia0
• Anisometropia
• Hyperopia
• Myopia
• Keratoconus
• Corneal Ectasia
• Other Corneal Deformities

 

Eyewear buy-ups

There are no buy-up options in the state of Ohio. If the Medicaid member wishes to purchase eyewear that exceeds their covered benefits, the member is responsible for paying out-of-pocket to cover the remaining costs.

 

Member ID cards 

Medicaid members will present Humana Healthy Horizons^® in Ohio ID cards like the ones below.

 

 

Related provider resources Provider Manual – Ohio Medicaid Registering for Medicaid network labs Filing claims for Medicaid Medically Necessary Contact Lens Form – Ohio Medicaid