Vision Care Framework

© Minister of Public Works and Government Services Canada, 2004
Cat. No. H1-11/2002E
ISBN: 0-662-37387-1

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(2 MB)

Version 1 January 2005

Non-Insured Health Benefits (NIHB) Program
First Nations and Inuit Health Branch

"Our mission is to help the people of Canada maintain and improve their health"

Table of Contents

Purpose
Privacy
NIHB Client Eligibility

NIHB Vision Care Benefits

• Eligibility Criteria
• Reimbursement for Vision Care Goods and Services
  • Reimbursement Criteria
  • Unclaimed glasses - Provider Reimbursement Process
• Prior Approval Process
• Eye and Vision Examinations
  • General Eye and Vision Examination
  • Specific Examination
  • Follow-Up Examination
  • Frequency Guidelines
• Glasses
  • Lenses (Ophthalmic)
    • Eligibility for Initial Lenses
    • Replacement Guidelines
    • Replacement Outside Replacement Guidelines
  • Specific Types of Lenses
    • Eligibility Criteria
  • Frames
• Warranty and Repairs
• Replacement guidelines
• Replacement Outside Replacement Guidelines
• Dispensing Fees
• Vision Care Exceptions
  • Contact Lenses
    • Replacement guidelines
    • Replacement Outside Replacement Guidelines
  • Tints and Coatings for Lenses
    • Replacement guidelines
  • Frames
    • Replacement guidelines
• Appeal Procedures
• Exclusions

NIHB Provider Audit Program
Nihb Eye And Vision Products And Services Prior Approval And Claims Form