NIHB Handbook - First Nations Health Council

1. EYE AND VISION CARE BENEFITSWhat is covered?Payment is made to the provider in the areas listed below. All eye and vision care benefits requireprior approval.General eye andvision exams if notcovered by a private,federal or provincial/territorial health planSpecific Eye ExamsFollow-Up ExamsFirst pair of eyeglassesReplacementeyeglassesEyeglass repairsEvery two years for a person 18 years old and over.Every year for a person younger than 18 years.When there is a change or correction in vision.* A person with diabetes should schedule regular eye exams asrecommended by their doctor.May be approved by a FNIHB Vision Care consultant on a case bycase basis;When a severe abnormality in ocular or visual condition requires athorough assessment using specific tests.Specific eye exams for diabetics will be approved as part of this process.May be approved by a FNIHB Vision Care consultant on a case bycase basis;When required by certain ocular or visual conditions.Specific eye exams for diabetics will be approved as part of this process.With a written prescription from the doctor.Lenses and frames up to a maximum amount determined by the regionalFNIHB office.Lenses include: unifocal (distance or near vision), aspheric, bifocal, orhigh index (HIL). Some restrictions apply.Every two years for a person 18 years old and over.Every year for a person younger than 18 years.An accepted amount of change or correction in vision is required accordingto NIHB guidelines.Lenses include: unifocal (distance or near vision), aspheric, bifocal,or high index (HIL). Some restrictions apply.The total cost of the repair must not be more than it would costto replace with standard frames.Within a two year period for a person 18 years old and over.Within a one year period for a person younger than 18 years.The repairs will make the glasses usable.*Replacement frames or sets of lenses are not eyeglass repairs.2