37.79.322    EYEGLASS BENEFITS

(1) Eyeglasses shall be paid by the department through a single volume purchase contract.

(2) An enrollee is limited to one pair of eyeglasses per 365 day period unless additional pairs are necessary due to any of the following circumstances:

(a) cataract surgery;

(b) .50 diopter change in correction in sphere;

(c) .75 diopter change in cylinder;

(d) .5 prism diopter change in vertical prism;

(e) .50 diopter change in the near reading power;

(f) a minimum of a 5 degree change in axis of any cylinder less than or equal to 3.00 diopters;

(g) a minimum of 3 degree change in axis of any cylinder greater than 3.00 diopters;

(h) any 1 prism diopter or more change in lateral prism; or

(i) the inability of the enrollee to wear bifocals because of a diagnosed medical condition.

(3) When the enrollee meets one or more of the conditions in (2) (a) through (2) (i) , the enrollee may be allowed two pairs of single vision eyeglasses per 365 day period.

(4) Contact lenses are not a covered benefit.

History: Sec. 53-4-1009, MCA; IMP, Sec. 53-4-1003, MCA; NEW, 2000 MAR p. 1221, Eff. 5/12/00; AMD, 2004 MAR p. 1027, Eff. 2/13/04.