NOW EVERYONE'S EYES ARE COVERED!
Coverage for vision services is dependent on age and medical necessity.
Ages 0 -18 and 65+
Alberta Health Care provides routine eye exam coverage for patients 0-18 years of age and 65 and older. For these age groups, most services are insured, but coverage is limited to one complete eye exam per year. There are some exceptions based on clinical need. For example, patients with glaucoma, diabetes, or cataracts may need additional "follow up" procedures. Ask your optometrist for more information about coverage and potential costs for specific visual conditions.
Ages 19 - 64
For patients of the ages 19 - 64, Alberta Health covers only medically necessary optometric services.
What is considered medically-necessary?
- Monitoring for diabetes issues, glaucoma and retinal disease
- Pre and Post-operative care for cataract patients
- Eye infections or injuries
- Foreign objects in the eye
- Sudden appearance of floaters, spots, or flashes of light
- Sudden changes in vision or acute pain in the eye
- Other visual disturbances may be covered... ask your optometrist!
The bottom line is, if you are unsure whether or not a service is covered, ASK BEFORE entering the exam room.
Coverage only applies to the procedures or services necessary to treat the immediate medical condition. A routine eye exam (see What is an Eye Exam
) is not covered for adults (19 - 64).
For those between the ages of 19 - 64, the cost of a non-insured eye exam can range from $75 to $150, depending upon the services provided. Other optometric services such as contact lens assessments and vision therapy are not insured by Alberta Health Care and are billed directly to patients. Services of this nature are discussed in advance with patients.
Glasses and Contact Lenses - All Ages
The cost of eyeglasses and contact lenses varies considerably depending upon the supplier, quality of materials and services provided. Feel free to shop around for the best price on eyewear. You are not required to purchase glasses or contact lenses from the same office you received your eye exam in. As long as you have a valid prescription, you can purchase your glasses from any retail outlet. Online eyewear purchases are not recommended.
Seniors may be eligible for financial assistance in purchasing eyewear. Click here
for more information.
Be aware of eyewear 'specials' which are often available only for products that are discontinued or of poor quality. Eyeglass frames, eyeglass lenses and contact lenses are very diverse in quality, thus prices can vary. Consumers should be encouraged to ask questions about their eyecare needs, costs and choices.
There are an increasing number of group insurance plans that cover optometry services that are not covered by provincial health plans. Ask your employer if insurance coverage is available, both for eyecare and eyewear.
The bottom line is, if you are unsure about whether or not you will be paying for a service, ask about it before entering the examination. This will ensure that there are no surprises and you can relax knowing you are getting the appropriate service at an affordable price.
Use the Find an Optometrist link in the top left corner to find a doctor of optometry near you.