Why This Is Important To Know
If you are seen by your Doctor of Optometry and:
- There is no coverage under your plan contract, or
- Your coverage has run out because you have exceeded the yearly limit of your plan, or
- Your Doctor of Optometry’s fees for a procedure exceed the amount your plan allows, or
- Your coverage has expired and you will be responsible for payment of the treatment.
Please note
There are times when we are not able to accommodate additional testing such as a Visual Field test during the same day of your Full Examination due to varying staff schedules. These additional tests are usually performed on specific days and are regarded as a separate fee from the full examination
Eye Examination fees and coverage
Eye examination fees vary by age group and type of diagnostic testing required. Typically, a full health eye examination for an adult ages 19-64 at our office is $140.00 and children under the age of 19 are covered by BC Medical for exams only with a valid & active BC Health Services Card. Our staff will be happy to provide more detailed information, based upon your needs. We strive to make our comprehensive, professional eye care accessible to all of our patients.
Regarding BC Medical Services Plan Coverage for eye examinations: BC seniors who are 65 or more years of age have partial coverage for most eye examinations through the BC Medical Services Plan (BC MSP). In most cases, children through age 18 have full coverage for preventive eye examinations through BC Medical (MSP). Regardless of age, almost all residents of BC are eligible for partial BC MSP coverage if an eye or general health problem or medical reason is detected during the examination, but this cannot be confirmed prior to assessment. Unfortunately, BC MSP does not cover preventive eye care for most adults 19-64 years of age.
Patients are required to pay, on the day of service, for any portion of their examination fees which are not covered by BC MSP. We will bill BC MSP directly for any services for which you are eligible, if you have a current BC Health Care Card or the new BC Services Card. We are also able to bill directly for examinations covered by RCMP and Department of Veterans Affairs. Unfortunately we are no longer able to direct bill for active Canadian Forces members, however we do supply a receipt for the member to submit for potential reimbursement.
We are able to also direct bill a small amount of extended health companies online. (Please see a list of companies below) If the company you use is not one of the few that we can bill directly, we will provide you with receipt of your payment to us so that you can apply for reimbursement according to your coverage.
You the patient are responsible for any, and all, parts of the treatment fee that is not covered by your insurance plan or BC Medical Services Plan. To be able to direct bill the companies below, your plan’s Policy number and ID number card must be brought to your appointment, we must be notified of your coverage upon checkout, and we must know if you have any secondary coverage or if your visit is WCB, ICBC or accident related.
Please ask our staff about this for more information if you have any questions.
We welcome individuals with BC Social Services (Ministry of Human Resources), First Nations
Health Authority (Status card) and Department of Veteran Affairs (Canada) coverage to schedule
appointments. We will assist you in obtaining approval for coverage of your eye examination
and/or eyewear.
However, please be aware that most organizations have strict
guidelines regarding the timeline for examinations and replacement of glasses.
We are able to also direct bill a small amount of extended health companies online. (Please see a list of companies below) If the company you use is not one of the few that we can bill directly, we will provide you with receipt of your payment to us so that you can apply for reimbursement according to your coverage. You the patient are responsible for any, and all, parts of the treatment fee that is not covered by your insurance plan or BC Medical Services Plan. To be able to direct bill the companies below, your plan’s Policy number and ID number card must be brought to your appointment, we must be notified of your coverage upon checkout, and we must know if you have any secondary coverage or if your visit is WCB, ICBC or accident related.
Please ask our staff about this for more information if you have any questions.
Companies we may be
able to direct bill on your behalf:
(Via our online portals)
We are able to also direct bill a small amount of extended health companies online. (Please see a list of companies below) If the company you use is not one of the few that we can bill directly, we will provide you with receipt of your payment to us so that you can apply for reimbursement according to your coverage. You the patient are responsible for any, and all, parts of the treatment fee that is not covered by your insurance plan or BC Medical Services Plan. To be able to direct bill the companies below, your plan’s Policy number and ID number card must be brought to your appointment, we must be notified of your coverage upon checkout, and we must know if you have any secondary coverage or if your visit is WCB, ICBC or accident related.
Please ask our staff about this for more information if you have any questions.
Contrary to popular belief our staff does not know which optical procedures or products are covered under your extended healthcare plan, and which are not. Your extended healthcare plan is a contract that exists solely between you and your insurance company. You, the patient, are responsible for educating yourself about such things as:
- Examinations, glasses or other products that are covered by your plan
- To what extent or percentage of the actual cost they are covered
- Annual maximums, procedure maximums within your plan
If you do not already have information that explains your benefits, you may want to ask your employer how your particular plan operates. Extended Insurance carriers consider the details of your plan to be a private matter since the Privacy Act was introduced in 2004, and will not provide information about your plan to a Doctor of Optometry or Optometric staff.