Glasses are available to registered Nisga’a citizens when the following conditions are met:
- The item has been prescribed within the last 12 months by an optometrist or ophthalmologist.
- Prior approval has been provided by NVHA’s MS&E/Vision Assessor.
- The item is not available to Nisga’a clients under a provincial, third party agency or health plan.
- The prescription meets the minimum eligibility criteria for initial or replacement eye wear or repairs.
What is covered (prior approval is required)?
- Eye examinations (the maximum payable for the vision exam is $46.17)
- Glasses (maximum payable for single vision is $155.00; maximum payable for bifocal vision is $222.00)
- Eyeglass repairs
- Eye prosthesis (artificial eye)
- Other vision benefits depending on your medical needs within your province or territory association
Criteria Used by NVHA’s NIHB Program:
- When there is a refractive error of at least 0.50 diopters
- High index lenses will be approved where there is a refractive error with a total power in any meridian of at least plus or minus 7.00 diopters
- For clients 18 and over, the frequency limitation is 2 years or a diopter change of 0.50
- For clients under 18, the frequency limitation is 1 year or substantial growth of child
Exclusions under the Vision Program:
- Progressive lenses
- Prescription sunglasses
- Special cosmetic features
- Laser Eye Surgery
- Safety glasses for occupational purposes
- Tint for cosmetic purposes
- Foldable intraocular lenses
How to Access Vision Program Benefits:
Step 1: Make an appointment with an optometrist or ophthalmologist.
Step 2: Have provider submit for prior approval on your behalf to the MS&E/Vision Assessor.
Step 3: Bring prescription to an optician or an optometrist.
Step 4: The provider will contact our MS&E/Vision Assessor for approval.
Step 5: Your glasses will be ordered and you can pick them up when they arrive.
What are your responsibilities?
The Non-Insured Health Benefits is the payer of last resort. Please claim under any other health plan before accessing Nisga’a NIHB.
Tell the provider that you are eligible to receive benefits under the Nisga’a NIHB Program, and provide your Great West Life Benefits number & your Nisga’a Citizenship Number.