Please note that this applies to Quebec Residents only.
Below you will find an excerpt from a recent Flash message from the ClaimSecure site announcing changes in the province of Quebec. (To view the bulletin “Click Here”):
Quebec’s RAMQ program recently added Vision Care funding to provide financial assistance for children under the age of 18. Funding is available for any purchases made on or after September 1, 2019. This program provides a $250 grant, every 24 months, to any child under the age of 18 following the purchase of prescription eyeglasses or contact lenses from a Quebec optician or optometrist. Residents must apply for the reimbursement and will be sent a cheque for the full $250 regardless of the actual purchase amount; it does not vary based on the cost of the purchase.
ClaimSecure will start enforcing the program for any purchases made on or after January 1, 2020. Members submitting Vision Care claims for dependents under 18 will have their claims automatically reduced by the $250 grant allowance with a cutback message of ‘Provincial funding applied.’ They will not have to provide any proof of obtaining the funding. Their private plan parameters will then be applied against the remaining cost of the expense.
The example in the bulletin however does not speak specifically to the coverage available in our plans at Mainline and Rouge.
Here are examples below:
The Mainline Air Canada Flight Attendant plan provides Vision Care (Frames and prescription lenses or prescription contact lenses, prescription sunglasses, safety glasses and goggles when dispensed by a licensed optometrist, optician or ophthalmologist) at $325.00 every 24 consecutive months per covered person from the last date of purchase.
An eligible claim is submitted for $400.00. The $400.00 claim is reduced by the $250.00 grant allowance leaving a claim submission amount of $150.00. The co-insurance* is applied and the claim is paid at $150.00 leaving $175.00 remaining in the coverage available to the plan member.
NOTE: This is provided no other claim has been paid within the previous 24 months.
The Basic plan at Rouge provides Vision Care (for glasses, contacts and laser eye surgery) at $150.00 every 2 years.
The Extended plan at Rouge provides $250.00 every 2 years.
Taking the same example from above, a $400.00 claim is reduced by the $250.00 grant allowance leaving a claim submission of $150.00. The basic plan would reimburse the remaining $150.00 of the claim. The extended plan would cover the remaining $150.00 of the claim and leaving $100.00 available for reimbursement of future eligible claims with the 2-year period.
NOTE: This is provided no other claim has been paid within the previous 2 years.
*Co-Insurance – (co-payment) – Co-Insurance refers to medical services or supplies whose reimbursement is limited to a certain percentage or dollar amount. This means that the plan will reimburse up to a certain percentage or dollar amount and the covered individual will be responsible for the balance.
Your Component Benefits Committee