Program Resources
Vision Care Voucher Applications
Healthy Eyes and Mobile Eyes Applications and Criteria

Application

If you are unable to afford vision care or glasses, Prevent Blindness Wisconsin may be able to help. Please fill out and submit the application below to see if you qualify.

English-Language Application

Spanish-Language Application

Hmong-Language Application

Criteria for Vouchers

MOBILE EYES:

Mobile Eyes is a program that is available to assist adults with the cost of an eye exam and glasses if needed. To qualify the following criteria must be met.

  • Family income is at or below 200% of poverty level
  • Is not covered by Medicaid or any other vision insurance
  • Has not used a voucher during the last 12 months

 

HEALTHY EYES:

Healthy Eyes Eyeglass Program is a program available to children and adults and covers the cost of eye glasses only. To qualify, the following criteria must be met.

  • Family income is at 200% of the current Federal Poverty Guidelines
  • Have a valid eyeglass prescription that is less than 12 months old
  • Do not have any other eyeglass benefits they can access
  • Have not previously participated in this program in the last 12 months

**Can only be used at Lens Crafters, Target Optical or Pearle Vision