Vision Care
Vision care coverage helps pay for prescription glasses, contact lenses, and sometimes laser eye surgery. It promotes preventive eye health and ensures access to corrective eyewear when needed.
Vision care refers to coverage for costs associated with eye sight, and usually entails eye examinations by a qualified doctor, prescription eyeglasses (lenses and frames), contact lenses, and laser eye surgery. The doctors who provide this care are classified as either optometrists, who hold a Doctor of Optometry degree, or ophthalmologists, who hold a Doctor of Medicine degree with special vision care training.
How It Works
In Canada there are two main sources of vision care coverage: publicly funded provincial healthcare plans and private health insurance, with private plans covering the vision care items that provincial healthcare does not. Government health insurance generally provides only limited coverage for eye exams to certain groups such as seniors, children, and lower-income individuals, and it does not usually cover prescription glasses or contacts. Most Canadian health insurance plans provide a specific maximum for vision care every one or two years, and laser eye surgery may be included as an alternative to eyewear within the same maximum. That coverage often renews on a benefit period that resets every 24 consecutive months rather than every calendar year, so the renewal cycle may differ from a calendar year. Within an extended health plan the benefit can reimburse a percentage of reasonable and customary charges; the federal Public Service Health Care Plan, for instance, provides 80 percent reimbursement for eligible eye exams, glasses, and contact lenses on a two-year cycle. Because laser eye surgery is considered elective and not medically necessary, it is not covered by provincial health insurance plans, making a laser eye surgery allowance a feature of private coverage.
Example:
Suppose you have a private health and dental plan in Canada that includes a vision care benefit covering glasses or contacts plus an eye exam on a two-year cycle. After a year of headaches you visit an optometrist, who confirms your prescription has changed. You buy new glasses, submit the receipt to your insurer, and the plan reimburses up to its stated maximum for the eyewear while you pay any amount above that limit out of pocket. Because provincial health coverage would not have paid for the glasses or, for most working-age adults, the routine exam, the private vision care benefit is what bridges that gap.
What to Watch For:
Confirm the renewal cycle, since vision care often resets every 24 consecutive months rather than every calendar year. The Canadian Association of Optometrists recommends that adults get an eye exam every two years to keep prescriptions current and detect problems such as glaucoma or cataracts early, so a two-year benefit period tends to line up with that schedule. A vision care plan can also qualify as a private health services plan (PHSP) under the Income Tax Act where coverage is limited to items such as prescription eyeglasses or contact lenses, eye examinations, and eye correction surgery for employees and their dependants, which is worth confirming if the plan is employer provided.
