You may have coverage for optometric services in Saskatchewan. Please see the coverage options below. If you have any questions, reach out to your optometrist’s office for more information.
All Saskatchewan Health Beneficiaries with a Valid Saskatchewan Health Card
Saskatchewan Health covers ocular health examinations with your optometrist for certain eye conditions including most red eye urgencies and emergencies and the new development of flashes and floaters. Optometrists have the training and equipment to most effectively treat eye emergencies. If you have experienced a sudden injury, changes to your vision, or you’re experiencing itchiness or discharge, you should contact your optometrist immediately.
Certain conditions are not eligible for coverage by Saskatchewan Health; please contact your optometrist’s office for case-specific information.
Work-related injuries are not eligible for reimbursement by Saskatchewan Health and patients are to present to their optometrist’s office with a claim number for Workers’ Compensation Board (WCB) or pay their optometrist directly and seek reimbursement through WCB on their own.
Supplementary Health and Family Health Benefits*
Saskatchewan Health notifies Saskatchewan Health beneficiaries who meet the eligibility requirements for these programs. Supplementary Health and Family Health Benefits insures examinations for persons aged 18 and older once every two years. Certain conditions may be eligible for coverage within the 2 year time period, please contact your optometrist for case-specific information.
Children under the age of 18 with Supplementary Health and Family Health Benefits are insured for examinations equivalent to all Saskatchewan Health beneficiaries, however they may also qualify for eyewear covered by Saskatchewan Health. This is prescription and need dependent; please contact your optometrist for case-specific information.
*Persons aged 18 and older with Supplementary Health Benefits may qualify for eyewear covered by Saskatchewan Health. This is prescription and need dependent; please contact your optometrist for case-specific information.
*Persons aged 18 and older with Family Health Benefits are covered for examinations as noted above, but there is no government coverage for eyewear.
*If you are unsure whether you are eligible for these government programs, you are advised to first call Saskatchewan Health directly using the phone number on the back of your health card.
Children
Saskatchewan Health covers the cost of annual eye exams for all children under the age of 18. Examinations provided within 365 days of an annual eye examination are covered for certain conditions; more details on coverage can be provided by contacting your optometrists office for case-specific information.
People Living with Diabetes
All Saskatchewan beneficiaries with a valid Saskatchewan Health Card who have been diagnosed with diabetes type 1 or 2 are eligible for an insured annual diabetic eye exam. A physician’s referral is not required to receive an insured diabetic eye exam; however, for those non-medicated patients a letter confirming the patient’s diagnosis is recommended.
Non-Insured Health Benefits (NIHB)
To qualify for NIHB, you must be a resident of Canada and any of the following:
- a First Nations person who is registered under the Indian Act (commonly referred to as a status Indian)
- an Inuk recognized by an Inuit land claim organization
- a child less than 18 months old whose parent is a registered First Nations person or a recognized Inuk
The NIHB program provides coverage for eye examinations when the individual is not already insured by the province or territory and corrective eyewear (glasses, contact lenses) when prescribed by an optometrist. The program may also cover repairs to eyeglasses. In situations where private insurance exists, the patients’ private insurance is to be billed first and the remaining balance (if any) may be submitted to NIHB for reimbursement up to a maximum amount set by NIHB. All services that are submitted to NIHB for reimbursement require prior approval by NIHB before the service may be provided.
Visit the Government of Canada’s webpage for more information.