What You Need to Know About Eye Exam Coverage for Seniors 65+ in Alberta
As we age, our eyesight may diminish, and we become more susceptible to various eye conditions. Regular eye exams with an optometrist are essential for seniors (65+) to maintain their vision and quality of life. But does Alberta Health Care cover the cost of these exams? Let's take a look at what you need to know about eye exam coverage for seniors in Alberta.
Alberta Health Care Coverage for Eye Exams
Eye exams are fully covered by Alberta Health Care once a year.
Between July 1-June 30th, every person 65 years of age and older are covered by Alberta Health Care for a comprehensive eye exam with an optometrist. This coverage includes a routine eye exam, a dilated eye exam if required, and an updated prescription for eyeglasses. This coverage means you do not need to pay any out-of-pocket expenses unless your doctor provides an uninsured service.
You may also be covered for additional eye exams and testing if you have any medical conditions such as:
diabetes
hypertension (high blood pressure)
glaucoma
age-related macular degeneration
cataracts
dry eye
floaters
retinal detachment symptoms
eye infections
droopy eyelids
visual concerns
Additional testing requirements include digital retinal photography, 3D-OCT Scans, and computerized visual field testing. In some cases, however, these tests may need to be performed on a separate day from your routine eye exam. If they are performed on the same day as your regular eye exam, you may be required to pay for these tests out of pocket. The optometrist, however, must explain this to you before proceeding with any testing.
SEE THE COMPLETE PICTURE
Optomap retinal imaging allows us to get a 220 degree field of view image inside the eye vs. the traditional 45 degree field of view provided by older retinal cameras and 3D oct scans. This technology is a game changer in primary care and allows you to see what we see.
You may also be covered or partially covered for eyeglasses if you have coverage under the Dental and Optical Assistance for Senior plan. To gain coverage under this program, you must meet the following requirements.
Be 65 years of age or older
Be an Alberta resident and have resided in Alberta for at least three months before applying
Be a Canadian citizen or admitted to Canada for permanent residence (landed immigrant)
Have submitted a completed Seniors Financial Assistance programs application form
Have an annual income within the limits allowed by the program
To learn more about this program, visit the link above for more information and how to apply.
Alberta Health Care Does Not Cover Second Opinions
Unfortunately, Alberta Health Care does not cover second opinions. Suppose you're unhappy with the service or experience you have at one optometry office. In that case, you can't get the same service again at another office. You would have to pay for this second opinion out of pocket.
As such, it's essential to ensure that the optometrist you choose to see has access to all the best equipment, such as 3D OCT Scans, Ultra Widefield Retinal Photography and Computerized Zeiss Visual Fields.
How to Access Your Eye Exam Benefits as a Senior
You only need to show your optometrist a copy of your Alberta Card to access your eye care benefits. However, you should also be prepared to show a valid government-issued photo ID to ensure that no one else is using your benefits.
Suppose you are covered under the Dental and Optical Assistance Program for seniors. In that case, you will also have an insurance card issued by Alberta Blue Cross, currently the administrative insurance company for this program.
Conclusion
At Helio Optometry, we offer in-depth eye care for patients of all ages, including seniors 65 and older. Our clinic is equipped with the newest eye care instruments, and our optometrists have over 25 years of practice experience in Edmonton. In addition, we employ Canadian Certified Ophthalmic Assistants for all your pre-testing and extra-exam testing.
Visit our senior's eye exams in Edmonton page to learn more and to book your eye exam online.
