Province to stop paying for mid-year eye appointments for at-risk kids, seniors

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It’s too late for a rush on eye appointments — the Alberta government’s cuts to partial eye appointments for children and seniors went into effect on Saturday, Feb. 1.

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“Partial vision examination for children and seniors, B651 in the Schedule of Optometric Benefits, will be delisted,” said a Jan. 3 bulletin on optometry coverage from Alberta Health.

The decision will have negative impacts on all Albertans, said a statement from Dr. Sophia Leung, president of the Alberta Association of Optometrists (AAO)

The AAO wasn’t consulted prior to the announcement, she said.

“We were blindsided,” Leung said.

In 2024, Alberta optometrists saw more than 1.1 million patients through Alberta Health Care.

Among those hardest hit by the changes are patients with special needs, low-vision patients, those with chronic eye conditions including glaucoma, macular degeneration, diabetes, retinal or neurological conditions.

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A new provision decreeing basic eye services will not be allowed to be billed on the same day as medically necessary eye care for children or seniors is expected to hit those with difficulties accessing transportation for multiple appointments, as well as rural Albertans who must travel distances for services.

“This will increase wait times for eye care, and if it’s an issue that needs a referral to a specialist, there is now an increase in wait times here, too. This also unnecessarily increases expense and hardship for vulnerable populations and rural Albertans who travel to see an optometrist,” Leung said.

Annual limits will be put on some services — retinal imaging and retinal photography cane be claimed up to twice per benefit year, and only one interpretation, so no second opinions.

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The number of services is capped at four per benefit year.

Under the provision, the rate the government pays optometrists for certain services will be cut.

Fees for computer assisted visual fields (technical and interpretation), retinal imaging and retinal photography and interpretation will be reduced.

Health Minister Adriana LaGrange maintains Alberta’s optometrists are funded at the top of the scale among provinces.

The changes are expected to save the province up to $8 million annually, said a note from LaGrange’s office.

“Ultimately, this approach ensures that health funding is used where it is most needed and helps maintain a fiscally responsible, sustainable, effective health care system that meets the evolving healthcare needs of all Albertans,” the LaGrange statement said.

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When patients put off appointments, it increases the risk of progression in eye diseases like age-related macular degeneration, glaucoma and diabetic eye disease, potentially leading to blindness if not managed according to evidence based standards of care, Leung said.

“Because the number of followup exams has been reduced, a patient will now pay out of pocket for needed followup exams. This will impact vulnerable populations and those on fixed incomes the most,” she said.

“These changes could lead to more patients with needless vision loss. If someone has diabetic eye disease and should be followed over a period of time for signs of eye health changes, this option is no longer available.”

The move downloads more health costs on to individual Albertans, said NDP’s shadow minister for health Sarah Hoffman.

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“It’s going to mean that fees go up for patients, or optometrists don’t provide those services, or that patients, when the fees go up, are going to skip those exams, so that they’re not going at all,” Hoffman said.

Moves list delisting the mid-year appointments for those most at risk smacks of American-style, private, two-tiered health care, she said.

“They think those who can afford to pay for it should make that choice, and the rest of us should be left behind,” Hoffman said.

“What we need is for Danielle Smith to focus on her actual mandate, which includes strong, public health care. And there’s more than enough work for her to do as a premier of Alberta to deliver on what she was actually elected to deliver, but, but she seems to be more focused on pandering to extreme folks and implementing American policies and American privatized health care.”

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