DIVISION 1
RULES OF APPLICATION
(1.1) Lenses and supplementary items
(1.1.1) Special benefits cover the cost of the lenses and supplementary items listed in subdivision 2.3 of Division 2 under the rates listed therein.
(1.1.2) The cost of both lenses is reimbursed where the weaker eye requires a correction of at least 0.50 dioptres or use of a prism prescribed as a supplementary item. The prism must provide a correction of at least 1 dioptre in the weaker eye.
(1.1.3) The cost of a lens is not reimbursed unless it was prescribed by an optometrist or a physician, except to replace a broken lens.
(1.1.4) The cost of replacing lenses is paid when the recipient’s vision requires a correction of at least 0.50 dioptres and, in the case of a dependent child, when the child’s growth so requires.
In the case of accidental breakage, damage or loss, the special benefit may not exceed 75% of the amounts listed in subdivision 2.2 of Division 2.
(1.1.5) A recipient who needs bifocal lenses but whose inability to wear them is certified by an optometrist or a physician is entitled to 2 pairs of glasses.
Special benefits may cover, for the purchase of those glasses, only the cost of the pair of bifocal lenses which the recipient is unable to wear, and the cost of 1 pair of frames under the rates listed in Division 2.
(1.2) Contact lenses
(1.2.1) Special benefits cover the cost of hard unifocal contact lenses, hard bifocal contact lenses, hard toric contact lenses and soft contact lenses provided on prescription under the rates listed in subdivision 2.4 of Division 2,
(a) upon medical or optometric prescription, when the correction otherwise obtained is not adequate and in any case of
i. myopia of at least 5 dioptres,
ii. hypermetropia of at least 5 dioptres,
iii. astigmatism of at least 3 dioptres,
iv. anisometropia of at least 2 dioptres,
v. keratoconus, or
vi. aphakia, or
(b) upon medical prescription, for treatment of any acute or chronic pathology of the eyeball, such as ocular perforation, ulceration of the cornea or dry keratitis.
(1.2.2) Special benefits cover the cost of replacing contact lenses under the rates listed in subdivision 2.4 of Division 2
(a) when the recipient’s vision requires a correction of at least 0.50 dioptres; and
(b) in the case of accidental breakage, damage or loss.
(1.3) Frames
(1.3.1) Special benefits cover the cost of purchasing 1 pair of frames under the rates listed in subdivision 2.5 of Division 2, once per 24-month period for an adult and whenever necessary for a dependent child.
(1.3.2) When an adult’s frames have been accidentally broken or lost, special benefits cover the cost of replacing the frames under the rates listed in subdivision 2.5 of Division 2; in such a case, the cost of another pair of frames may be paid only 24 months after the date of replacement.
DIVISION 2
RATES
(2.1) General
(2.1.1) The notion of “replacement” used in this Schedule concerns situations where a special benefit has already been granted to pay the cost, as the case may be, of a pair of frames, lenses or contact lenses.
(2.1.2) The rates in this Division apply for 1 lens, except for the replacement of 2 contact lenses.
(2.1.3) The rates in this Division for one bifocal lens apply to a round bifocal lens.
(2.1.4) The cylinder must always be calculated in minus terms (-) to determine to which category a spherical or spherico-cylindrical lens belongs.
(2.2) Lenses
Spherical power | Cylindrical power | Unifocal lens | Bifocal lens |
Plano to 4.00 | | $17.40 | $34.80 |
Plano to 4.00 | -0.25 to -3.00 | $22.80 | $42.60 |
Plano to 4.00 | -3.25 to -6.00 | $31.20 | $50.40 |
4.25 to 10.00 | | $23.40 | $40.80 |
4.25 to 10.00 | -0.25 to -3.00 | $33.00 | $55.20 |
4.25 to 10.00 | -3.25 to -6.00 | $41.40 | $63.60 |
10.25 to 12.00 | | $36.60 | $85.80 |
10.25 to 12.00 | -0.25 to -3.00 | $45 | $93 |
10.25 to 12.00 | -3.25 to -6.00 | $49.20 | $100.20 |
(2.3) Supplementary items
Prism 1 to 7 dioptres: $7.20
Prism 7.25 to 10 dioptres: $10.80
Compensatory prism: $30
Spherical exceeding 12 dioptres: $16.80
Cylindrical exceeding 6 dioptres: $13.20
Addition exceeding 4 dioptres: $10.80
Fresnel lens: $16.80
Safety mineral lens (dependent child only): $4.80
Scratch-resistant coating for organic lenses (dependent child only): $4.80
High index unifocal lens (1.6 or more) if there is a correction of at least 8 dioptres: $26.40
(2.4) Contact lenses
(2.4.1) Purchase or replacement when the correction required is at least 0.50 dioptres
— Spherical lens: $75 each
— Toric lens: $78 each
(2.4.2) Replacement due to accidental breakage, damage or loss
— 1 lens: $60
— 2 lenses: $114
(2.5) Frames
— Purchase: $60
— Replacement due to accidental breakage or loss (adults): $48