Closing the Gaps

Provincial health plans and group vision care plans do not cover the latest clinical standards of practice,

Provincial Coverage

Provincial health plans do not cover vision care for working-age Canadians, with some exceptions for those with a diagnosed eye disease. This makes group vision care plans critically important for the diagnosis of eye diseases and maintenance of the vision health of working Canadians. 

Coverage varies by province and territory. Check with each jurisdiction for details on coverage. Use the links for more information on your province or territory’s coverage for vision care.

Vision Care in Canada: Public Coverage Grid

Public funding of vision care varies by province. Some provinces offer limited coverage for children, seniors, and working-age adults who are diagnosed with certain conditions. Coverage of advanced diagnostics and imaging tools, like OCT, is rare. 

Working-age Canadians rely almost exclusively on their workplace group insurance plans for vision care. Where this falls short, gaps in care arise unless patients pay out of pocket. For various reasons, many opt not to.

Download the Public Coverage Grid

Did you know?
1 in 4 Canadians who have access to vision care benefits report not receiving services they need due to cost. 

[Abacus 2020]

Group vision care plans

Gaps in group vision care plans have developed as new clinical standards of practice and supporting technologies have become available, while group vision care coverage has not changed. 

By filling the gaps in vision care, insurers and plan sponsors can demonstrate their willingness to provide best practice coverage that meets the needs of plan members. Not only is this a tool for attracting and retaining talent, but it will also avoid the significant burden from drugs, absenteeism, presenteeism and long term disability associated with the advanced stages of eye disease.

Vision Care Benefits Handbook

More information on common eye diseases, the impact on quality of life, modern diagnostic and imaging tools, and closing the gaps in vision care can be found in the CAO Handbook.

For a one-on-one discussion about vision care or a hard copy of the Handbook contact info@opto.ca.

Download the handbook

 

Who benefits from changing the scope of vision care coverage?

Insurers

Insurers will be offering best practice vision care to help plan sponsors reduce presenteeism and benefit costs associated with vision loss.

Employers

Employers will be providing a benefit that will help attract and retain talent, and avoid some of the significant workplace burdens of vision loss.

Individuals

Individuals will receive preventative care, along with early diagnosis and treatment of serious eye diseases to reduce vision loss.

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