Blog Hero

Does Alberta Health Care Cover Eye Exams?

Book Appointment

Eyes exams are essential for protecting your eye health and vision, helping your optometrist identify early signs of eye disease. While eye exams are necessary, some people may avoid receiving one due to cost concerns. Can you count on government support to cover the cost when you need an eye exam?

Continue reading to learn more about eye exams, including if Alberta Health Care can cover the cost of your exam. 

The Importance of Eye Exams

Comprehensive eye exams are important because they help your optometrist get a complete picture of your eye health and vision. They consist of several tests to identify signs of eye diseases and other problems. After diagnosing any present issues, your eye doctor can recommend a treatment plan. 

Many people assume they don’t need to visit the eye doctor if they can see clearly, but your exam is much more than a vision screening. Many eye diseases can develop symptom-free, slowly progressing until they affect your vision. An undiagnosed problem may lead to severe vision loss. 

Some common eye diseases include: 

These diseases can significantly affect your eye health and vision, but your optometrist can identify these problems in their earliest stages during an eye exam. An early diagnosis means sooner treatment, which can help prevent further damage to your ocular health

Eye Exam Frequency

Eye exam frequency depends on several factors, such as your age and medical needs. According to the Canadian Association of Optometrists, a healthy adult between 19–64 requires an eye exam every 2 years. Older adults over 65 should have an annual eye exam. 

Remember that these are guidelines—your eye doctor may recommend they see you more frequently if you have a medical condition or a risk of eye disease. Always listen to your optometrist’s recommendation, and book your eye exams accordingly. 

Does Alberta Health Care Cover Eye Exams?

The short answer is yes, Alberta Health care does cover eye exams. However, these services require you to meet certain conditions. The Alberta Health Care Insurance Plan (AHCIP) provides partial coverage for optometry services in Alberta only, for a specific limit per year. 

Let’s learn more about what this means. 

Partial coverage means that someone has a specific limit that the AHCIP covers, requiring you to pay any costs over this number. According to the Government of Alberta’s website, when the charge for a service exceeds the benefit limit, you or your secondary insurer must pay the difference. To avoid additional fees, always discuss your treatment details and costs with your eye doctor before proceeding. 

The Details of the Alberta Health Care Insurance Plan

The AHCIP covers certain optometry services, but only in Alberta, such as eye exams. The AHCIP coverage has its limits, so it’s important to understand what parts of your eye care it supports. 

The AHCIP covers the following optometry services

  • An annual comprehensive eye exam for children under 18 years old & older adults over 65. This exam is eligible once per benefit year (July 1 to June 30). 
  • Fully-covered treatment for some specific medical conditions treated by optometrists. Your eye doctor cannot charge you for AHCIP-covered services, but you must pay any additional costs. 
  • Complete coverage for anyone 19–65 for an eye exam your doctor deems medically needed. An eye exam may be necessary due to trauma, a medical condition, or an episode of illness. 

Ask your eye doctor about any questions you have about the AHCIP.

What to Expect During Your Eye Exam

You experience several tests during your comprehensive eye exam, including how well you can see, your visual skills, and an eye health assessment. Expect to take an active role during your exam—your optometrist will ask you several questions about your eye health and vision. 

Your comprehensive eye exam will include: 

Medical History

Your eye doctor will have a discussion with you about your medical history. This conversation includes your family history and any current medications you take, your lifestyle, and any problems you’re facing. Knowing your medical history helps your eye doctor better understand your eye health. 

Visual Acuity

A visual acuity test determines how well you can see. It involves looking at a series of letters on a chart. 

Preliminary Tests

You experience several preliminary tests to get an initial impression of your eye health and vision. These tests include your depth perception, colour vision, and peripheral vision.

Eye Health Evaluation 

Your optometrist takes an in-depth look at your eye’s internal structures during your eye health evaluation. They will examine your eyes using several different technologies, helping your eye doctor identify early signs of eye disease. 

Book Your Next Eye Exam

Regular eye exams are essential for protecting your eye health and vision, but you shouldn’t need to worry about your bill. The Alberta Health Care Insurance Plan can help cover your eye exam. Ensure you know your coverage and what additional charges you may have. 

Contact your optometrist when it’s time for your next eye exam. 

Written by Donald Bishop

In addition to his Doctor of Optometry from the University of Waterloo, Dr. Bishop also earned his pharmacological therapeutics certification from Northeastern State University of Oklahoma. He graduated in 1983 and has been practising optometry in Alberta ever since.

More Articles By Donald Bishop
instagram facebook facebook2 pinterest twitter google-plus google linkedin2 yelp youtube phone location calendar share2 link star-full star star-half chevron-right chevron-left chevron-down chevron-up envelope fax