The following article is excerpted from a special series on vision care, published by Benefits and Pensions Monitor magazine, and featuring an interview with our own Paula Grossman.
The following article is excerpted from a special series on vision care, published by Benefits and Pensions Monitor magazine, and featuring an interview with our own Paula Grossman.
Vision care benefits can be a proactive tool to protect eyesight and reduce long-term health costs, particularly eye disease. Yet, some plan sponsors still treat them like a simple subsidy for eyeglasses or contact lenses.
“Often, vision benefits are perceived as a prepaid benefit plan for glasses, rather than what it could be, which is comprehensive coverage aimed at preserving vision, diagnosing eye disease early, and addressing impairments or preventing disabilities at an early age." Paula Grossman, Health Benefits Consultant, Medavie Blue Cross.
Paula believes that plan sponsors are falling behind, particularly when it comes to people with chronic vision conditions like dry eye disease, which has surged in recent years due to increased screen time.
“Most benefit plans haven't evolved to reflect how crucial eye health is to overall wellness and workplace productivity.”
“Canadians’ eye health is under increased strain due to the combined effects of aging and prolonged screen time. And the cost of eye exams has been rising significantly as optometrists are investing in a lot of new technology.”
Additionally, most people don’t interpret dry eye disease as an eye disease, Paul emphasized, noting that the average person might dismiss it as a minor annoyance rather than the productivity-sapping condition it is.
“They don't necessarily understand how debilitating that could be.”
Despite its impact, treatment options such as LipiFlow (a medical treatment that uses thermal pulsation technology to treat the glands in your eyelids) or follow-up diagnostics remain out-of-pocket expenses for most employees.
“Canadians’ eye health is under increased strain due to the combined effects of aging and prolonged screen time. And the cost of eye exams has been rising significantly as optometrists are investing in a lot of new technology.”
Additionally, most people don’t interpret dry eye disease as an eye disease, Paul emphasized, noting that the average person might dismiss it as a minor annoyance rather than the productivity-sapping condition it is.
“They don't necessarily understand how debilitating that could be.”
Despite its impact, treatment options such as LipiFlow (a medical treatment that uses thermal pulsation technology to treat the glands in your eyelids) or follow-up diagnostics remain out-of-pocket expenses for most employees.
Prescription lenses, glasses, and, in some cases, laser surgery are typically covered under benefit plans because they fall within the scope of eligible medical expenses as defined by the Canada Revenue Agency.
However, products like eye drops, even if used for conditions like screen-related dry eye, are excluded from coverage since they don’t qualify as health expenses under the Income Tax Act.
There’s also a troubling mismatch between the cost of advanced care and the coverage limits. Optometrists are investing heavily in new technologies to catch diseases early, but these costs are bundled into increasingly expensive eye exams that remain under-reimbursed.
“Current best practices in vision care include the use of advanced technologies, and those are often built into the comprehensive eye exams,” Paula said, noting that people over 40 may require multiple follow-up appointments to monitor conditions but these costs aren't often reimbursed under standard plans.
The Canadian Institute for Health Information (CIHI)’s 2016 national health expenditure trends found that approximately 74 percent of private vision care expenses were paid out of pocket, compared to 37 percent for prescription drugs and 44 percent for dental services.
This has consequences for both plan members and employers, leading to poor vision and affecting workplace safety, absenteeism, and presenteeism, all of which are costing employers more than they may realize.
“Expanding vision care coverage can serve as a competitive advantage in attracting and retaining top talent, as vision benefits are highly valued by employees, second only to dental coverage,” noted Paula.
Medavie Blue Cross recently updated its offerings to better reflect modern clinical practices. These include separate coverage for follow-up exams, higher maximums for multifocal lenses, and even benefits for visual training therapy, especially in cases like concussion recovery and vertigo.
Paula emphasized the growing need for coverage around intraocular lens implants, procedures that were once confined to cataract patients but are now increasingly sought after by individuals who’ve undergone laser eye surgery.
“We’re seeing more and more requests for people who have had laser eye surgery asking for the lens implant coverage as well.”
Medavie Blue Cross recently updated its offerings to better reflect modern clinical practices. These include separate coverage for follow-up exams, higher maximums for multifocal lenses, and even benefits for visual training therapy, especially in cases like concussion recovery and vertigo.
Paula emphasized the growing need for coverage around intraocular lens implants, procedures that were once confined to cataract patients but are now increasingly sought after by individuals who’ve undergone laser eye surgery.
“We’re seeing more and more requests for people who have had laser eye surgery asking for the lens implant coverage as well.”
Paula noted that inadequate vision care coverage has the potential to drive up drug claims, increase disability leave, and even lead to premature retirement.
“We believe it’s important to invest in prevention because, if left unmanaged, advanced stages of eye disease can negatively impact benefit budgets. Vision care is one of the top health benefits... Just give it a little attention.”
Make sure you’re aware of the vision care benefits available through your insurance. Eligible Medavie Blue Cross members enjoy enhanced coverage for eye exams, specialized imaging, glasses, contact lenses, and vision therapy.
Additionally, members can purchase discounted eyewear through KITS, a Canadian eyewear provider, as part of Medavie Blue Cross’s Connected Care suite of health and wellness services.
Medavie Blue Cross is a premier all-in-one carrier that provides health, dental, travel, life and disability benefits and administers federal and provincial government-sponsored health programs. Together with Medavie Health Services, we are part of Medavie, a health solutions partner committed to improving the wellbeing of Canadians. We are in the...