Changes are coming to optometry coverage for Alberta children and seniors

Alberta Health will change optometry coverage Health Minister Adriana LaGrange says changes are coming to vision care coverage for children and seniors. Jacqueline Wilson reports.

Effective Feb. 1, Alberta's UCP government will be decreasing payments and delisting some services for children and seniors.

This could put optometrists in a tough spot to either absorb the cost or pass it onto patients.

The biggest change is partial eye exams for children and seniors will no longer be covered by the province.

The changes are being made as Alberta's health minister says the province spends the most on optometry services for residents.

"Alberta is also the only jurisdiction in Canada that covers an annual partial routine eye exam for children and seniors, in addition to a complete eye exam every year," a statement from the Health Minister Adriana LaGrange's office said.

However, the BC’s Doctors of Optometry says their province does cover partial exams.

“In British Columbia, the Medical Services Plan contributes towards partial eye examinations for children up to the age of 19 and seniors aged 65 and older, as well as for adults with medically necessary ocular conditions,” a statement from Dr. Evelyn Lo, President of BC Doctors of Optometry, said.

One complete eye exam each year is still covered for children and seniors in Alberta.

Also, basic eye services will not be allowed to be billed on the same day as medically necessary eye care for children and seniors.

Optometry coverage changes for Albertans

The province will also pay optometrists less for retinal imaging and interpretation, among other things.

"We are working to better align program costs with other provinces, and to make responsible decisions when it comes to funding the priorities of today, maintaining core services, paying off debt, and saving for the future," the statement said.

Rate changes effective Feb. 1, 2025:

Partial vision examination for children and seniors, (B651) in the Schedule of Optometric Benefits, will be delisted;

Fees for computer-assisted visual fields technical (B906) and interpretation (B907) components will be reduced;

Fees for retinal imaging (technical (B908) and interpretation (B909) components) and retinal photography (technical (B910) and retinal interpretation (B911) components) will be reduced;

Retinal imaging and retinal photography (technical and interpretation components) may be claimed up to twice per patient per benefit year regardless of the practitioner providing the service. Only one interpretation is payable per technical service; and

Basic eye services (B650) will not be allowed to be billed on the same day as medically necessary eye care (B900-B904) for the same patient by any provider in the children and seniors category.

CTV News has reached out to the Alberta Association of Optometrists for comment on the changes.