Great News for CareFirst Families

Luminopia Is Now Covered by CareFirst for Qualifying Patients

Our FDA-cleared lazy eye (amblyopia) treatment* — which allows children to watch TV to improve their vision instead of wearing an eye-patch — is now more affordable for your family.

Luminopia is now covered by CareFirst for eligible members.

How to Access Luminopia Through CareFirst

Step 1 — Talk to Your Doctor About Luminopia

Ask your child’s eye doctor if Luminopia is right for them. If your doctor is unfamiliar with prescribing Luminopia, they can visit the Healthcare Professional tab on our website for additional information.

If you are looking for a provider near you already familiar with Luminopia:

FIND A PRESCRIBER NEAR YOU

Share your CareFirst insurance information with your doctor so they can include it on the Luminopia prescription. This allows our partner, CoAssist Pharmacy, to verify your coverage quickly to determine if you meet CareFirst’s eligibility criteria.

CoAssist will reach out to you directly if your insurance information is missing from your prescription, so nothing slows down your child’s access to treatment.

Step 3 — We’ll Take It From There

If your medical benefits indicate CareFirst coverage, will work with your doctor to secure CareFirst coverage and reach out to you by secure text message throughout the process to keep you updated. Once your prescription is with Pentec, you are welcome to contact them to discuss your coverage status at 866-751-1077.

What Will Luminopia Cost with CareFirst Coverage?

Luminopia is covered by CareFirst as a medical benefit. That means for eligible CareFirst members your insurance will help pay for it — but you might still need to pay part of the cost. How much you pay depends on your insurance plan.

Here is a simple explanation of how it works.

Key Terms to Know

Insurance plans have a few rules about who pays what. These four words are important to understand:

Key Terms

What It Means (in plain English)

Deductible

The amount you pay yourself before insurance starts contributing.

Copay

A flat fee you pay each time.

Coinsurance

You and your insurance split the cost. If your share is 20%, you pay 20% and your insurance pays 80%.

Out-of-Pocket Maximum

The most you will ever pay in one plan year. Once you hit this limit, your insurance pays 100% for the rest of the year.

How Much Will I Pay?

Your cost depends on where you are in your insurance year. Here are the three situations you might be in:

Your Situation

What You’ll Pay

Haven’t met your deductible yet

You pay the full cost yourself right now. But don’t worry — this money counts toward your deductible, so you’re getting closer to insurance helping.

Met your deductible, but not your max

Your insurance starts helping! You pay your share — either a flat copay (like $50) or a percentage (like 20%). Your insurance covers the rest.

Met your out-of-pocket maximum

Great news — your insurance pays 100%! You pay nothing for covered services for the rest of the plan year.

Note: Cost-sharing varies by plan. Some plans use copays (a flat fee), others use coinsurance (a percentage). Check your insurance card or call the number on the back if you’re unsure.

Supporting Every Patient, Every Step of the Way

Prescription Status Assistance

If you haven’t received a text from CoAssist confirming your prescription — or a request for additional information — within 3 business days, you can contact CoAssist directly to check on your prescription status at (855) 382-2533.

Concerned About Cost?

We’ve got you covered, whether your plan covers Luminopia (for your child) or not. We’re committed to ensuring every patient prescribed Luminopia can access therapy. If you’re concerned about cost, Luminopia access programs may be able to help.

Additional Questions?

More Info Here

Luminopia: Directions For Use, LBL-0001 Rev E. Luminopia, Inc; 2025.
Xiao, S., Angjeli, E., Wu, H. C., Gaier, E. D., Gomez, S., Travers, D. A., Binenbaum, G., Langer, R., Hunter, D. G., Repka, M. X., & Luminopia Pivotal Trial Group (2022). Randomized Controlled Trial of a Dichoptic Digital Therapeutic for Amblyopia. Ophthalmology, 129(1), 77–85. https://doi.org/10.1016/j.ophtha.2021.09.001.
Data on file, 2023. Luminopia, Inc.
Li, J., Thompson, B., Lam, C. S., Deng, D., Chan, L. Y., Maehara, G., Woo, G. C., Yu, M., & Hess, R. F. (2011). The role of suppression in amblyopia. Investigative ophthalmology & visual science, 52(7), 4169–4176. https://doi.org/10.1167/iovs.11-7233
Birch, E. E., Jost, R. M., Wang, Y. Z., Kelly, K. R., & Giaschi, D. E. (2019). Impaired Fellow Eye Motion Perception and Abnormal Binocular Function. Investigative ophthalmology & visual science, 60(10), 3374–3380. https://doi.org/10.1167/iovs.19-26885
Wallace, M. P., Stewart, C. E., Moseley, M. J., Stephens, D. A., Fielder, A. R., Monitored Occlusion Treatment Amblyopia Study (MOTAS) Cooperatives, & Randomized Occlusion Treatment Amblyopia Study (ROTAS) Cooperatives (2013). Compliance with occlusion therapy for childhood amblyopia. Investigative ophthalmology & visual science, 54(9), 6158–6166. https://doi.org/10.1167/iovs.13-11861

Link to Healthcare Professionals Site

The information contained in this section is intended for U.S. healthcare professionals only.