Using Vision Care Insurance in Canada: A Complete Guide

Vision care is an essential part of maintaining overall health, and in Canada, many people rely on vision care insurance to cover the costs of prescription glasses, contact lenses, and eye exams. Whether you are looking to get new prescription glasses, upgrade your eyewear, or simply have a routine eye exam, vision insurance can help reduce the financial burden. Here’s what you need to know about using vision care insurance in Canada, including the coverage, benefits, and how to make the most of it.

What is Vision Care Insurance in Canada?

In Canada, vision care insurance is typically part of a health benefits plan offered through an employer, but individuals can also purchase it privately. These plans help cover the cost of eye care services that are not typically covered by provincial health insurance plans. While provincial plans cover basic health needs, such as medical visits and hospital care, they do not typically cover routine eye exams or glasses.

Vision care insurance is designed to cover or partially cover expenses for the following:

• Eye exams

• Prescription glasses and contact lenses

• Laser eye surgery (in some cases)

• Eye health treatments and services

Each insurance plan varies in coverage, so it’s important to review the specifics of your plan.

What Does Vision Care Insurance Cover in Canada?

Vision care insurance plans often cover a portion of the costs for eye exams and eyewear, including prescription lenses and frames. The coverage varies by plan and may include:

1. Eye Exams

Routine eye exams are typically covered once every one or two years, depending on your plan. Adults over the age of 65 or children may be eligible for more frequent coverage. However, it’s important to note that provincial health insurance often covers eye exams for children under 19 and adults over 65, so your insurance may not need to cover this.

2. Prescription Glasses

Vision care insurance can provide coverage for prescription glasses, including the cost of lenses and frames. Some plans cover the entire cost of basic frames and lenses, while others may only cover a portion, leaving you responsible for the remainder. Higher-end frames, such as designer eyewear or frames with special features like Asian fit, may have higher co-pays or a separate allowance.

3. Contact Lenses

If you prefer contact lenses over glasses, many vision care insurance plans will cover the cost of contact lenses, either partially or fully. Insurance plans may set annual or biennial limits on the amount that can be claimed for contact lenses.

4. Laser Eye Surgery

In some cases, vision insurance will cover a portion of the costs for laser eye surgery (such as LASIK). However, this is typically not included in standard coverage and may require additional riders or a separate insurance policy for surgery.

5. Additional Eyewear Benefits

Some vision insurance plans offer extra benefits, such as discounts on anti-reflective coatings, blue-light filtering lenses, and other lens upgrades. These can be especially beneficial for individuals who spend a lot of time in front of screens or in environments with low light.

How to Use Your Vision Care Insurance in Canada

Using your vision care insurance in Canada is simple if you follow these steps:

1. Verify Your Coverage

Before purchasing new glasses or scheduling an eye exam, it’s essential to check with your insurance provider to verify your coverage. Make sure you understand what’s included, any limits on benefits, and whether you need a referral for certain services.

2. Find an Eligible Eye Care Provider

Not all eye care providers accept every insurance plan, so it’s important to ensure that your optometrist or optician accepts your vision care insurance. You can contact your insurance company to get a list of approved providers in your area.

3. Submit Claims

Once you’ve visited the eye care provider and purchased eyewear, the provider may submit your claim directly to the insurance company on your behalf. However, some insurance companies may require you to pay for services upfront and submit a claim yourself. Be sure to keep receipts for any services or products purchased to submit your claim.

4. Pay Any Co-pays or Deductibles

Some vision care insurance plans have co-pays or deductibles that you’ll need to cover yourself. For example, if your plan only covers 80% of the cost of prescription glasses, you may need to pay the remaining 20%. Make sure you are aware of these costs before making any purchases.

5. Use Annual Benefits Wisely

Most vision care insurance plans have annual limits for eyewear. This means that if your plan covers $200 for prescription glasses annually, you’ll need to make the most of that amount. Consider upgrading to premium lenses or specialty eyewear (such as Asian fit glasses) that work well with your lifestyle needs while staying within your insurance limit.

Tips for Maximizing Your Vision Care Insurance

• Shop smart: Look for frames and lenses that fall within the plan’s allowance but still meet your needs. Consider durable materials and premium lenses that offer long-lasting value.

• Combine benefits: Some insurance plans allow you to combine eyewear and contact lens benefits. This is useful for individuals who switch between glasses and contacts.

• Consider upgrades: Take advantage of any available lens upgrades, such as blue-light protection or anti-reflective coatings, which may improve the overall quality of your eyewear.

Asian Fit Eyewear and Insurance Claims

For individuals who require Asian fit eyewear, vision care insurance can typically be used to cover the cost, but it’s important to check whether there are any specific frame restrictions. Asian fit glasses are designed to accommodate lower nose bridges and higher cheekbones, and they often come with adjustable nose pads for extra comfort. These frames may cost more than regular ones, but many insurance providers are willing to cover the extra cost, especially if the frames are medically necessary for comfort or fit.

Final Thoughts: Navigating Vision Care Insurance in Canada

Vision care insurance can help ease the financial burden of eyewear and eye exams in Canada, but it’s important to understand the specifics of your plan. By choosing the right coverage and working with your insurance provider, you can enjoy affordable and comfortable eyewear tailored to your needs.

If you're considering Asian fit eyewear, remember to check with your insurance provider to confirm that these frames are covered. With the right plan and knowledge, you can get the most out of your vision care insurance and enjoy clear, comfortable vision. 👓

Are you ready to use your vision care insurance for your next pair of glasses? Let us know how we can help!