“Is my eye exam covered?”
We hear this question every day, and the honest answer is that it depends. Your age, your eye health and your benefits plan all affect what you’ll pay.
If cost is the reason you’ve been putting off an eye exam, this guide will help. We’ll walk through how MSP coverage works in BC and what extended health plans usually include. We’ll also cover what an exam costs at Nicola Eye Care and how direct billing works at our downtown Kamloops clinic.
Are eye exams covered in British Columbia?
Some are. BC’s Medical Services Plan (MSP) covers one routine eye exam a year for children under 19 and adults 65 and older. Adults aged 19 to 64 are covered only when an exam is medically required, such as for eye disease, an injury or diabetes. Extended health benefits can help with routine exams, glasses and contact lenses, depending on your plan.
Source: Government of BC, Eye Examination Benefits | Reviewed: October 19, 2026
Are Routine Eye Exams Covered by BC Provincial Health Care?
MSP covers certain eye exams for BC residents. Your age and the reason for your visit decide which coverage applies.
A routine exam checks your vision and overall eye health. A medically required exam investigates or monitors a specific health concern.
MSP coverage doesn’t always pay the full exam fee, so there may be a balance for you to pay. You’ll find our current fees further down this page.
If you’re 19 to 64 and don’t qualify for MSP coverage, your extended health benefits may help with the cost.
Source: Government of BC, Eye Examination Benefits
Who Qualifies for Medically Required Eye Exam Coverage?
A medically required eye exam looks into a specific concern with your eyes or visual system. Under MSP guidelines, this generally includes:
- Eye disease, trauma or injury
- Health conditions that carry significant risk for your eyes, such as diabetes
- Medications that carry significant risk for your eyes
A prescription change on its own doesn’t qualify. If you’re 19 to 64 and booking only to update your glasses or contacts, MSP won’t cover the exam.
Having a health condition also doesn’t mean every exam is covered. MSP covers medically required exams at set intervals, such as once every 6, 12 or 24 months, depending on the condition. Your optometrist will determine during your exam whether your visit meets MSP’s criteria.
If you have an eye emergency, call us right away at (250) 374-2441. We try to fit in emergency appointments for new and existing patients. Extra testing may increase your exam fee, and in rare cases we’ll recommend going straight to the ER.
Source: Government of BC, Eye Examination Benefits
Are Children’s Eye Exams Covered?
Yes. MSP covers one routine eye exam every year for children under 19.
At Nicola Eye Care, there’s no clinic fee for kids under 10. From age 10, we include ultra-wide retinal imaging for a fee of approximately 34–40. The fee can be slightly higher for kids who also wear contact lenses.
Does MSP cover children’s glasses?
No. MSP covers the exam, not frames and lenses. Eligible low-income families can get help with prescription glasses through BC’s Healthy Kids Program, which covers qualifying lenses and basic frames. Families with extended health benefits may also have an eyewear allowance.
Kids don’t always notice when their vision changes, which is why yearly exams matter once they start school. For what to expect at your child’s appointment, read our guide to kids’ eye exams in Kamloops.
Source: Government of BC, Healthy Kids Program
Are Seniors’ Eye Exams Covered?
Yes. MSP covers one routine eye exam a year for BC residents 65 and older.
Vision and eye health change as we age, and many conditions develop without early symptoms. A yearly exam helps your optometrist watch for:
- Cataracts
- Glaucoma
- Age-related macular degeneration
- Changes in how clearly you see
Medically required exams are also covered when they meet MSP’s criteria and timing limits. Glasses and some additional testing aren’t included, but extended health benefits may help with those costs.
Source: Government of BC, Eye Examination Benefits
What Do Extended Health Benefits Cover?
Extended health benefits help many BC residents with vision costs MSP doesn’t cover. You may have coverage through your employer, a spouse’s or parent’s plan, or a plan you bought yourself.
Every plan is different. Some give separate allowances for eye exams and eyewear, while others combine them under one maximum. Here’s what plans commonly include.
Eye exams
Many plans cover part or all of a routine eye exam, up to a set amount and frequency.
Prescription frames and lenses
Most vision benefits include an allowance toward prescription glasses. Your plan may set limits on lens upgrades or coatings.
Contact lenses
Some plans include contact lenses in the same eyewear allowance as glasses. Others set separate limits.
Prescription sunglasses
Prescription sunglasses often qualify under your eyewear allowance. Non-prescription sunglasses usually don’t, so check your policy.
Dry eye treatment and specialty services
Coverage for specialty lenses and treatments varies by insurer. Don’t assume IPL or RF dry eye treatment falls under your eye exam coverage. Check with your provider first.
Having vision benefits doesn’t mean every service is covered in full. Your insurer decides what it reimburses based on your policy.
Does Nicola Eye Care Direct Bill?
Yes. We submit directly to most extended health providers, including Pacific Blue Cross, Canada Life, Sun Life, Manulife, Green Shield and Desjardins Insurance. You’ll find the full list on our Eye Exams page.
A few exceptions:
- We can’t submit to provincial plans that aren’t on our list.
- We can’t submit to Teck Sun Life or to Sun Life policies beginning with 055555.
- TRU students are billed through Green Shield using their TRU student ID.
If you haven’t signed up for e-claims, or your plan needs a manual submission, you may need to pay for your exam and submit the claim yourself. We can’t tell ahead of time whether this applies to you. We also can’t look up your coverage, because that information is confidential and only you can access it. Check with your provider before your appointment so there are no surprises.
If you have two plans, ask both providers how coordination of benefits works. Your second plan may cover some of what your first plan doesn’t.
How Much Does an Eye Exam Cost in Kamloops?
At Nicola Eye Care, adult eye exams start at $140. Your final fee can go up or down depending on what your optometrist finds.
- MSP coverage: If your optometrist finds you’re eligible based on your eye health, BC Medical may cover a portion of your exam. Plan to pay as little as $92 and as much as $160.
- Ministry coverage: If you’re covered through the Ministry (social services, disability or PWD), the Ministry covers about $44.83. You pay the remaining amount.
- Extra testing: If you come in with an eye concern or emergency that needs supplementary testing, your fee may increase.
- Contact lenses: Contact lens exams may need extra tests and can include a fitting fee. New wearers pay for the initial fitting and training, and the final contact lens check is free.
- Kids: MSP covers a child’s eye exam every year until they turn 19. There’s no clinic fee for kids under 10. From age 10, ultra-wide retinal imaging is included for a fee of approximately 34–40.
What Should You Ask Your Insurance Provider?
Your provider is the only one who can confirm your coverage, so a quick call before your appointment saves surprises. Ask:
- How often does my plan cover a routine eye exam?
- How much does my plan cover for an eye exam?
- Do I have a separate allowance for glasses and lenses?
- Are contact lenses and prescription sunglasses covered?
- Am I signed up for e-claims, or does my plan need manual submission?
- Do I need a referral or pre-authorization?
- When do my vision benefits reset?
- What is the deadline for submitting a claim?
- How does coordination of benefits work if I have two plans?
Some plans reset every calendar year, while others run on a rolling schedule. Knowing your reset date helps you plan your exam and eyewear purchases.
What Should You Bring to Your Eye Exam?
For insurance and billing, bring:
- Your BC Services Card
- Your benefits card or plan details, including your group and policy numbers
- Policyholder information, if you’re covered under a family member’s plan
- Your TRU student ID, if you’re billing through TRU Benefits
For everything else to bring, like your current glasses and a list of medications, see what to expect at your eye doctor appointment.
Frequently Asked Questions
Does MSP cover routine eye exams for adults?
Not for adults aged 19 to 64. MSP covers exams for this age group only when they’re medically required, such as for eye disease, an injury or diabetes. A prescription change alone doesn’t qualify.
Are children’s eye exams covered in BC?
Yes. MSP covers one routine eye exam every year for children under 19. At Nicola Eye Care, there’s no clinic fee for kids under 10. From age 10, ultra-wide retinal imaging is included for a fee of approximately 34–40.
Are seniors’ eye exams covered in BC?
Yes. MSP covers one routine eye exam a year for BC residents 65 and older. Medically required exams are also covered when they meet MSP’s criteria.
Does extended health insurance cover eye exams?
Many plans do, but coverage amounts and frequency vary. Check with your provider before your appointment.
Does Nicola Eye Care direct bill?
Yes. Nicola Eye Care submits directly to most extended health providers, including Pacific Blue Cross, Canada Life, Sun Life, Manulife, Green Shield and Desjardins Insurance. If you haven’t signed up for e-claims or your plan needs a manual submission, you may need to pay for your exam and submit the claim yourself.
Can Nicola Eye Care look up my insurance coverage?
No. Your benefit details are confidential and only you can access them. Check with your provider before your appointment to confirm what your plan covers.
How much does an eye exam cost in Kamloops?
At Nicola Eye Care, adult eye exams start at $140 and can go up or down depending on what your optometrist finds. If you’re eligible for partial MSP coverage, plan to pay between $92 and $160. Extra testing for an eye concern or emergency may increase the fee.
Are glasses covered separately from the eye exam?
MSP doesn’t cover glasses. Many extended health plans include a separate eyewear allowance, so check your plan.
What happens if insurance doesn’t cover the full amount?
You pay the remaining balance. If you have a second plan, it may cover some of what your first plan doesn’t.
Book Your Eye Exam at Nicola Eye Care in Kamloops
Knowing what’s covered makes it easier to book the exam you’ve been putting off. Check your benefits, bring your cards, and we’ll handle the claim if your plan supports direct billing.
Our team offers comprehensive eye exams for adults, kids and seniors at our downtown Kamloops clinic on St. Paul Street. Questions about fees or billing? Call us at (250) 374-2441.
This article provides general information about eye exam coverage in BC and isn’t insurance or medical advice. MSP rules and benefit plans can change, so confirm your coverage with Health Insurance BC or your benefits provider.
