Vision Coverage

If you are 65 or older, OHIP will cover the cost of an eye examination by an Ophthalmologist (but not by an optometrist), once a year. The McGuinty government has delisted OHIP coverage of eye examinations for other age groups as of November 1, 2004.

For the time being, PSHCP will continue to pay for eyeglasses and contact lenses, with the following restrictions:

You, and your covered dependents, may claim 80% of up to a maximum of $200 EACH toward the cost of eyeglasses or contact lenses purchased during each fixed two-year period under the Vision Care Benefit. It is important that the purchase date reflected on the receipt falls within the appropriate fixed two-year period which began January 1st, 2003 and will end December 31st, 2004. The next period will begin January 1, 2005, and end two years later.

The fixed two-year period is the same for every plan participant. To be eligible, eyeglasses or contact lenses must be necessary for the correction of vision and must be prescribed by an ophthalmologist.

There is no limit on the initial purchase of eyeglasses or contact lenses which are required as the direct result of surgery or an accident. However, the eyeglasses or contact lenses must be purchased within six months of the related surgery or accident. If the claim is as the result of surgery, the date of the surgery and whether it was on the right or left eye or both must be so indicated on the claim form.

If you have questions or concerns relating to this, or any other PSHCP coverage area, I should be pleased to try to provide a satisfactory response. Telephone: 737-2199 Mon. through Fri. between the hours of 10:00 a.m. and 4:00 p.m.

Jean Aslin, Health Benefits Officer, Ottawa Branch
15 November, 2004