Coverage of Eye Exams in British Columbia

For most people between the ages of 19 and 65 routine eye exams are self-paid and not covered by the B.C. Medical Services Plan. Private medical plans, provided though work, or self-insurance, in most instances cover most if not all the cost of a regular eye exam. The major private health providers such as Pacific Blue Cross, Great West Life, Sun Life, and Manulife to name a few usually have help lines you can phone to determine your coverage. Although most providers do not allow us to direct bill them we will happily help fill out and sign any required forms that you need to claim those benefits.

ALERT! EXTENDED MEDICAL BENEFITS EXPIRE ANNUALLY! 

Routine eye exams are paid for by B.C. Medical for certain groups of people. If you are a Senior Citizen 65 Years or older, or a Young Person under the age of 19, you are covered for a fixed amount towards your exam every year. If you fall within these guidelines simply supply us with your B.C. Medical Personal Health Number (PHN) when you book your appointment or when you come in and we will bill B.C. Medical for your exam. Many Optometric offices extra bill between the amount B.C. Medical pays and what the practice charges for their non-covered exams. At Eyeworx the Doctor of Optometry does not extra bill, so the exam is fully covered.

Examinations for eye problems (no prescription for glasses or contacts given) are still covered. If you have certain medical conditions, for example Diabetes, Glaucoma, Cancer, the doctor may be able to bill part of the regular exam through B.C. Medical. This billing will reduce the amount you will pay for the exam. To allow us to bill for this amount simply provide us with your B.C Medical PHN. If you have questions about coverage for certain conditions, or the end cost of the exam please call us and we will try to answer those questions.

People with certain Government plans also have coverage for eye exams. People on disability or social assistance are usually covered by provincial plans for an exam every two years. First Nations and Inuit peoples are also covered every two years by the Federal First Nations and Inuit Health Program. Most Canadian veterans have coverage every two years through the veterans' affairs department. To find out if you are eligible for these programs contact us with your B.C. Medical PHN, and if applicable First Nations Status Number or Veterans DVA Number and we will contact the respective agencies for authorization of your eye exam. And again at Eyeworx we do not extra bill on these plans.

http://www.health.gov.bc.ca/msp/infoben/benefits.html#eyeexam