Highmark Vision Insurance 2027: Medicare, ACA and Medicaid Coverage and Providers

Reviewed November 6, 2026. Highmark vision insurance comes built into most Highmark Medicare Advantage plans, Highmark ACA plans for children, and Highmark’s Medicaid plans, and Highmark vision benefits are run by Davis Vision. In 2027, Highmark Medicare Advantage plans in Pennsylvania cover a routine eye exam for $0 in network and cover standard glasses or contacts, with a $200 to $600 yearly maximum for non-standard frames or specialty lenses depending on the plan. Benefits vary by plan and county, so check your plan’s Evidence of Coverage.

Quick answer: To find who accepts Highmark vision near you, go to medicare.highmark.com and click Find a Provider in the page footer (Medicare members), or use the provider search for your plan on highmark.com, and look for “Routine Vision Care Providers.” Davis Vision locations, including Visionworks stores, are in the network. Call the eye doctor to confirm they take your specific Highmark plan before your visit.

Highmark vision plans at a glance

Highmark Medicare Advantage vision benefits for 2027

Original Medicare does not pay for routine vision care. Medicare.gov says, “Medicare doesn’t cover routine eye exams (sometimes called ‘eye refractions’) for eyeglasses or contact lenses” (medicare.gov: routine eye exams). Highmark Medicare Advantage plans add that coverage. In its October 1, 2026 announcement, Highmark said it will keep offering Medicare Advantage in all states and counties it served in 2026 (Pennsylvania, Delaware, West Virginia and New York), with “small to moderate changes” to benefits for some members (Highmark 2027 press release).

Highmark’s 2027 Annual Notices of Change say, “Davis Vision, Inc. is a separate company that administers Highmark vision benefits.” Here is how the eyewear benefit works: standard eyeglass lenses and frames from the Davis Vision collection, or standard contact lenses, are covered, and a dollar maximum applies to non-standard frames or specialty contact lenses. A separate amount covers glasses after cataract surgery.

Highmark vision: 2026 vs 2027

Highmark’s 2027 Annual Notices of Change show a few vision changes that apply across several plans:

• Diabetic eye exams drop to $0. In Complete Blue PPO Signature (H3916-041-002), the 2026 cost was a “$35 copay for diagnostic eye exam per day”; for 2027 it is a “$0 copay for annual diabetic retinal diagnostic eye exam,” with $35 for other diagnostic eye exams. Freedom Blue PPO Valor in central and northeastern PA (H3916-043-000) goes from $10 to $0, and Community Blue Medicare HMO Signature (H3957-047-003) goes from $25 to $0.
• Davis Collection frame copays rise. In the same plans, Fashion frames stay $0, Designer frames go from $15 to $25 and Premier frames from $35 to $40.
• Eyewear maximums mostly hold. Freedom Blue PPO Basic in central and northeastern PA keeps its $225 maximum, while its premium falls from $41 in 2026 to $5 in 2027 (2026 Summary of Benefits). Security Blue HMO-POS also stays at $225.
• Specialist copays can change. In Community Blue Medicare HMO Signature (H3957-047-003), the specialist copay that also applies to Medicare-covered eye exams rises from $25 to $35, and eye exams were added to telehealth.

If you are comparing plans during Open Enrollment (October 15 to December 7, 2026), read the vision row in each plan’s Summary of Benefits, and see Medicare changes for 2027 for the bigger picture. For other Pennsylvania options, see Pennsylvania Medicare Advantage plans.

Highmark vision providers: who accepts Highmark vision near me?

Highmark’s 2027 provider directory tells Medicare members to visit medicare.highmark.com and “click on Find a Provider in the footer of the page” (Highmark 2027 provider directory). The printed directory has a “Routine Vision Care Providers” section. Because vision benefits are run by Davis Vision, eye doctors and optical stores in the Davis Vision network (including Visionworks) generally accept Highmark vision, but always confirm that the office takes your plan.

1. Open the provider search for your plan and plan year (2027 networks can change on January 1).
2. Choose vision or routine eye care and enter your ZIP code.
3. Call the office and give your Highmark member ID to confirm coverage.
4. Ask which frames are in the Davis Collection tier you want (Fashion, Designer or Premier) and what you will owe.

Highmark Medicare Member Services numbers

Highmark vision on ACA (individual and family) plans

Highmark says, “All Highmark plans in these states include pediatric vision coverage,” for Delaware, Pennsylvania and West Virginia, and “Some Highmark ACA plans include optional adult dental and vision coverage” (Highmark ACA FAQ). In New York, all Highmark ACA plans include pediatric dental and vision.

The 2026 Highmark West Virginia ACA brochure gives an example. Children under 19 get an eye exam and glasses or contacts once every 12 months at $0, with $0 Davis Vision collection frames and a $150 allowance for other frames. “Vision benefits utilize the Davis Vision Network. There is no out-of-network coverage.” Adults get vision only on plans with “Adult Dental and Vision” in the plan name, which cover one annual exam plus a frame allowance “up to $130 retail” or a contact lens allowance “Up to $150.”

Highmark Medicaid vision: Wholecare and Health Options

Highmark Wholecare (Pennsylvania Medicaid): “Highmark Wholecare covers two necessary eye exams each calendar year,” and “A $100 credit each calendar year helps pay for glasses and contacts.” Members under 21 get glasses and contacts, including replacements if lost, broken or stolen (Highmark Wholecare vision). Call 1-800-392-1147 (TTY 711).

Highmark Health Options (Delaware Medicaid): the 2025 member quick guide lists “an annual eye exam with no copay” and a choice of select frames or contacts for adults 21 and older, and “one pair of glasses or contact lenses per year” for children 20 and under. Member Services is 1-844-325-6251 (TTY 711), Monday to Friday 8 a.m. to 8 p.m. For how Medicaid vision works in general, see Does Medicaid cover eye exams, glasses and contacts?

What Original Medicare covers for eyes

• Glasses after cataract surgery: “Part B covers one pair of eyeglasses with standard frames (or one set of contact lenses)” after surgery that implants an intraocular lens; you pay 20% after the Part B deductible (medicare.gov).
• Glaucoma tests: once every 12 months for people at high risk (medicare.gov).
• Diabetic eye exams: Medicare covers a diabetic retinal eye exam, which Highmark’s 2027 plans list at $0 in many cases.
• Routine exams and glasses: not covered; you pay all costs without extra coverage.

Other carriers handle vision differently. Compare with Wellpoint vision, or see how carriers handle hearing in Aetna hearing aids coverage 2027. Some plans also let you use a flex or OTC card for eyewear; see what OTC benefits cover.

Frequently asked questions

Who is Highmark’s vision provider?

Davis Vision. Highmark’s 2027 Medicare documents say Davis Vision “administers Highmark vision benefits,” and Highmark’s ACA plans use the Davis Vision network.

Does Highmark Medicare Advantage cover glasses?

Yes, in the plans we reviewed. Standard glasses or contacts are covered, and a yearly maximum (for example $225 in Freedom Blue PPO Basic, H3916-012, or $600 in Highmark Wholecare Medicare Assured Diamond, H5932-012, for 2027) applies to non-standard frames or specialty lenses.

Who accepts Highmark vision near me?

In-network eye doctors listed in Highmark’s provider search under routine vision care, which includes Davis Vision locations such as Visionworks. Confirm with the office before your visit.

Can I buy Highmark vision insurance by itself?

Highmark’s 2026 individual ACA brochure for West Virginia does not list a standalone vision plan; vision comes with medical plans (pediatric on all plans, adult on “Adult Dental and Vision” plans). Employers can buy group vision plans such as Blue Edge Vision.

Is the routine eye exam free with Highmark Medicare?

In the 2027 Pennsylvania plans we checked, the in-network routine eye exam is $0. Out-of-network costs differ by plan; HMO plans may not cover out-of-network exams.

This article is general information. Medicare365 is an independent website and is not affiliated with or endorsed by Highmark, Davis Vision, Medicare or any government agency. Benefits vary by plan and county and can change each year; check your plan’s Evidence of Coverage or call Member Services.

Sources

• Highmark: Highmark remains committed to Medicare Advantage members in 2027 (October 1, 2026)
• Highmark 2027 Summary of Benefits: Freedom Blue PPO Basic H3916-012 (PDF)
• Highmark 2027 Summary of Benefits: Security Blue HMO-POS H3957-045-002 (PDF)
• Highmark 2027 Summary of Benefits: Freedom Blue PPO Valor H3916-067 (PDF)
• Highmark 2027 Summary of Benefits: Community Blue Medicare HMO Signature H3957-042-004 (PDF)
• Highmark Wholecare 2027 Summary of Benefits: Medicare Assured Diamond H5932-012 (PDF)
• Highmark 2027 ANOC: Complete Blue PPO Signature H3916-041-002 (PDF)
• Highmark 2027 ANOC: Freedom Blue PPO Valor H3916-043-000 (PDF)
• Highmark 2027 ANOC: Community Blue Medicare HMO Signature H3957-047-003 (PDF)
• Highmark 2026 Summary of Benefits: Freedom Blue PPO, central and northeastern PA (PDF)
• Highmark 2027 provider directory (PDF)
• Highmark: ACA plans FAQ
• Highmark 2026 West Virginia ACA product brochure (PDF)
• Highmark Wholecare: Medicaid vision benefits
• Highmark Health Options Delaware 2025 quick guide (PDF)
• Medicare.gov: routine eye exams
• Medicare.gov: eyeglasses and contact lenses
• Medicare.gov: glaucoma screenings