In B.C., public health insurance is called the Medical Services Plan (MSP). It can cover or partially cover the cost of medically- necessary insured doctor services.
What are medically required services?
In general, medically required services cover:
- Ocular disease, trauma or injury
- Systemic diseases associated with significant ocular risk (e.g. diabetes)
- Medications associated with significant ocular risk
Optometric services not covered by MSP
Optometric services not covered by MSP include:
- Recommended treatments such as eyeglasses, contact lenses, low vision aids, eye co-ordination exercises, eye medications
- Contact lens fitting
- Eye examinations that are required by potential employers or other third parties
- Laser refractive surgery management (pre- and post-operative visits)
How much do I have to pay for an eye exam?
Medical Services Plan (MSP) provides limited or partial coverage for optometric services as a benefit* for the following population groups:
- Children aged 0–18 years: one full eye examination annually
- Adults aged 19–64: eye exams not covered by MSP unless medically required
- Seniors aged 65+: one full eye examination annually
* MSP currently covers:
- $47.08 for a full eye exam
- $32.96 for a minor or follow-up examination
Doctors of optometry are eligible to set their own fees for services and may bill MSP on behalf of their patients when there is coverage available. Patients are expected to pay the balance, if there is one. In advance of an appointment, the patient should be advised of the expected cost of the services, and whether MSP may cover any or all of it.
Can I get additional coverage for my child?
The BC Healthy Kids Program helps middle- and low-income families with the costs of basic dental care and prescription eyewear for their children. Eligible clients include dependent children under 19 years of age who receive MSP premium assistance through the Ministry of Health.