Ocular Prostheses – Services Covered
If you are eligible for the program and meet the eligibility requirements, you are entitled, for each eye, to a reimbursement for the cost of purchasing or replacing an ocular prosthesis once per five-year period, and to a yearly allowance for the repair and maintenance of the prosthesis.
Please note
If an ophthalmologist prescribes the replacement of a prosthesis because of a change in your orbital cavity, you are entitled to a reimbursement even if five years have not elapsed. However, you must submit a medical prescription dated and signed by an ophthalmologist and attesting to the change.
The amounts are as follows:
- $585 for a custom prosthesis made by a certified ocularist;
- $225 for a manufactured prosthesis;
- $25 per calendar year for repair and maintenance. The first $25 is not paid until 12 months after the prosthesis was purchased.
Since December 1, 1998, the program has also covered the purchase and fitting of conformers.
The amounts are as follows:
- $187 for each custom-made conformer;
- $112 for each prefabricated conformer.
Please note
If you have private insurance at the time you receive an ocularist's services, check with your insurance company. You may be covered for the difference between the cost of the services and the amount reimbursed by the Régie.
For recipients of last-resort financial assistance, the Régie pays the entire cost of purchasing and fitting each conformer, the entire cost of purchasing or replacing the prosthesis, as well as the full cost of repairs and maintenance.
