Local optometrists say they were not consulted on a slew of changes to optometry benefits coverage, and some could Albertans will face higher costs and possibly delayed care.
The Optometric Benefits Amendments were announced in January and came into effect Feb. 1., 2025, including delisting partial vision examinations for children and seniors.
The Alberta Association of Optometrists (AAO) said their organization was not consulted in these decisions.
"We were blindsided by the changes," said AAO president-elect Dr. Cristy Franco. "Alberta Health announced them on a Friday late afternoon with no consultation from optometrists in Alberta."
"It was very surprising," said St. Albert optometrist and AAO council member Dr. Karen Hayward. "One of the biggest frustrations was not having an opportunity to explain how this can impact our patients."
She said after the announcement the AAO presented some of that information, but the changes went ahead anyway.
With only a month from when the changes were announced to when they took effect, Franco said there wasn't a lot of time for their organization to figure out how to ensure their patients "can still get the care they need."
The change to delist partial eye exams for children and seniors could lead to higher fees for some Albertans.
"If during a full eye exam we are maybe not able to complete that in one visit, maybe that patient has some complex visual needs, or maybe they're just not able to sit through the full exam — there is no longer Alberta Health coverage for that patient to come back on another day to complete the followup exam," Franco said.
"There is a potential for out of pocket expenses if they are in for a visit that requires specific imaging or a specific concern that's no longer covered by Alberta Health," Hayward said.
Another change was to remove coverage for a full eye exam and a medically necessary eye exam on the same day for children and seniors.
"Now Albertans will need to come back on a separate day for any medically necessary testing," Franco said, like for a dilated eye exam.
"There's definitely a bit of inconvenience for sure, especially if our patients are coming from more rural areas or have mobility issues," Hayward said. "This can increase wait time for eye care. It can delay any needed referrals to specialists and really unnecessarily increase the expense and hardship for the vulnerable populations and especially rural Albertans who have to travel."
Hayward said that vulnerable populations, like individuals with chronic eye conditions, would likely be affected the most because they require multiple visits.
"And since the frequency of some of the imaging has been reduced by half, if they do require more than what the government is providing those patients, you will see some out of pocket expenses to have that specific testing covered," she said.
She also said wait times and emergency patients could be affected by these changes.
"Typically, we always do try to have availability for same-day emergency patients," Hayward said. "And so I think that's maybe going to change a little bit as we have to now have patients back for additional testing if needed. That's going to fill up our schedule with otherwise what could have been an opportunity for a same-day emergency to come in."
A statement from the health minister's office said Alberta's spending on optometry is the highest in the country, and the Feb. 1 changes will better align Alberta's coverage with other Canadian jurisdictions.
"Ultimately, this approach ensures that health funding is where it is most needed and helps maintain a fiscally responsible, sustainable, effective health care system that meets the evolving health care needs of all Albertans,"
"Alberta is the only jurisdiction in Canada that covers an annual partial routine eye exam for children and seniors, in addition to a complete eye exam every year."
Hayward said communicating the changes to patients has caused confusion.
"A lot of these rules in terms of frequency of billing are on a case-by-case basis," she said. "It's not easy for us to articulate, I guess. We have to almost look at every individual patient asking and kind of give them an idea on how it's going to impact them. So that makes it confusing, right?"
Franco encouraged patients to reach out to their optometrist to see how the changes might impact them.
"We want to make sure that Albertans are still receiving the care that they need and that they deserve," she said.
