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October 2019

Quebec offers partial refunds for children’s glasses and contact lenses

When the Quebec government presented its budget last March, it announced that the cost of children’s glasses and contact lenses would be partially refunded as part of a broader initiative to help kids succeed at school. The See Better to Succeed program was officially confirmed on September 12 and applies retroactively to September 1, 2019.

Under this program, the Régie de l’assurance maladie du Québec (RAMQ) will provide a $250 reimbursement per 24-month period for purchases made after September 1, 2019. This is a fixed amount regardless of the costs incurred. Claims must be submitted to the RAMQ using the form. Please note that eye exams for children under the age of 18 are already covered by Quebec’s health insurance plan.

Children are eligible for the new program if they:

  • Are under the age of 18 on the date of purchase
  • Have a valid Quebec health insurance card
  • Received a prescription for corrective glasses or contact lenses during an eye exam conducted by an authorized optometrist or ophthalmologist
  • Purchased their corrective glasses or contact lenses in Quebec

Some conditions apply. The complete list of conditions and new program terms are available on the RAMQ website.

IMPACT ON PRIVATE GROUP INSURANCE PLANS

Normandin Beaudry has discussed this matter with several major insurance companies. It seems that reimbursement procedures vary substantially between insurers and many haven’t formally decided how they will process these claims.

We expect that insurers will discount the first $250 from corrective eyewear claims for children and only cover the remaining portion of the cost, up to the maximum allowed under the plan. The new program’s impact on a group plan’s costs will depend on its terms, the group’s claims profile and the proportion of insured individuals in Quebec. We anticipate that it will be less than 1% of health care costs.

 

Would you like more information?
Contact your Normandin Beaudry consultant or email us.