Program for Elementary Eye Care

What does this program cover?

The Program for Elementary Eye Care helps cover the costs of annual eye exams and up to 3 pairs of glasses, if needed, for children in grades 1 to 6. 

If glasses are prescribed, Health PEI will provide reimbursement, after any insurance is applied, up to $300 for regular lenses or $350 for specialty/bifocal lenses.

Why is this program important?

• One in four school-age children has a vision problem, but many don’t realize it. Regular eye exams are crucial, as 80% of learning is visual.
• Annual eye exams help detect vision issues early, leading to better outcomes and support for your child's learning.

What does the eye exam include?

An optometrist will assess:

• Visual acuity
• Lazy eye and crossed eyes
• Nearsightedness, farsightedness, and astigmatism
• Eye coordination and depth perception
• Color vision
• Overall eye health

Who is eligible?

To be eligible, your child must: 

• be enrolled in or eligible to be enrolled in grades 1 to 6; and
• have a current PEI Health Card.

Please note:  Eligibility for the program ends if you move away from PEI and/or when your child completes grade 6.

If I’m registering during the summer break, what grade is my child in?

We consider September 1 to be the beginning of a new school calendar year.  For example, if your child is starting grade 7 in September, they are still considered to be a grade 6 student until August 31 of the same year.

How to participate in this program?

A. REGISTER 

Families must complete the online registration form to register their child for the Program for Elementary Eye Care. They will receive an email confirming their child’s eligibility for the program within 1-2 business days of completion of the online form. 

• Note: Without proof of eligibility, optometrists and other providers will require families to pay the full cost of the service. Families must register their child prior to submitting any claim(s) for reimbursement to Health PEI. Claims must be submitted within 90 days from when the service (eye exam or glasses) was provided.

B. EYE EXAM INFORMATION

1. Book an Exam:  

Call an optometrist to schedule an eye exam. If you need help finding one, view the listing of PEI Optometrists.

2. Visit the Optometrist:  

Bring the child’s PEI Health Card to the appointment and their confirmation of eligibility for the Program for Elementary Eye Care.

3. Insurance Information:  

If the family has private vision insurance, bring the insurance card/information. Costs will be billed to the insurance provider first, with Health PEI covering any remaining amount.

If the family doesn’t have insurance, Health PEI will cover the full cost of the exam.

C. GLASSES INFORMATION  

1. Visit a Glasses Provider:

Bring the confirmation of eligibility for the Program for Elementary Eye care to the family’s preferred glasses provider. 

2. Order the Glasses:

Order glasses through the family’s preferred provider in PEI. Claims submitted for glasses purchased on-line will be denied. 

3. Insurance Information:

If the family has private vision insurance, bring the insurance card/information. Costs will be billed to the insurance provider first, with Health PEI providing reimbursement, up to $300 for regular lenses or $350 for specialty/bifocal lenses.

D. SUBMITTING EXPENSES

To submit an invoice for reimbursement for an eye exam or glasses:

• Child must be registered in the Program for Elementary Eye Care.
• Claims must be submitted within 90 days from when the service (eye exam or glasses) was provided.
• Complete the online reimbursement form and include any private insurance documentation, your invoice and in the case of glasses – the prescription.
• Please allow 4-6 weeks for reimbursement.
• Claim submission examples:
  • No insurance (exam + bifocal glasses):
    • Health PEI pays 100% of eye exam
    • Covers up to $350 for bifocal lenses
    • Family pays any amount over $350
  • Private insurance (direct billing – exam + regular glasses):
    • Insurance covers 70% of exam + $160 for glasses
    • Health PEI covers remaining 30% exam + up to $300 for glasses
    • Family pays any amount over $460 total (ins + HPEI) for the regular glasses
  • Private insurance (pay upfront – exam + specialty glasses):
    • Insurance covers 80% of exam + $320 for glasses
    • Health PEI covers remaining 20% exam + up to $350 for glasses
    • Family pays any amount over $670 (ins + HPEI) total for the specialty glasses

Optometry offices only:

• Complete the online reimbursement form for Optometrists and include any requested documentation.

How do I contact the Program for Elementary Eye Care? 

Vision Care Programs
199 Grafton Street
Charlottetown, PE   C1A 1L2

Telephone:  902-213-2970
Email:  VisionCare@ihis.org