From the Hotline: ACA and Adult Vision Coverage

Question: Does the Affordable Care Act require that medical plans include adult vision coverage?

Answer: Adult vision coverage is not considered an essential health benefit (EHB) and therefore is not required to be provided to employees under the Affordable Care Act (ACA). While pediatric vision coverage is considered an EHB, it is only required to be included for nongrandfathered plans in the small group market. Large group and self-funded plans are not required to cover EHBs; however, if they do, they must comply with the ACA requirements governing those EHBs.