# PSHCP For Retiree



## 06Honda (20 Feb 2020)

My wife is getting Cataract Eye surgery which was advised by an eye specialists due to her having a rare eye disorder. Basically the cost to us is $1,500.00 dollars. Will the PSHCP cover any of this. Laser eye surgery is covered up to a lifetime maximum of $1,000 (reimbursed at 80%) per plan participant. Is this considered Laser Surgery? Couldn't find anything in booklet about Cataract Eye Surgery. Thanks for any info on this, much appreciated.


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## Blackadder1916 (20 Feb 2020)

06Honda said:
			
		

> My wife is getting Cataract Eye surgery which was advised by an eye specialists due to her having a rare eye disorder. Basically the cost to us is $1,500.00 dollars. Will the PSHCP cover any of this. Laser eye surgery is covered up to a lifetime maximum of $1,000 (reimbursed at 80%) per plan participant. Is this considered Laser Surgery? Couldn't find anything in booklet about Cataract Eye Surgery. Thanks for any info on this, much appreciated.



No, it is not Laser Eye Surgery.  Is your cost for an "intraocular lens" (IOL)?  If so, then it is an eligible expense under the vision benefit.  However, the amount is limited to "reasonable and customary charges" which they currently say is $950 (and of course, they only reimburse 80% of that).

http://www.pshcp.ca/coverage/extended-health-provision/vision-care-benefit.aspx


> Intraocular lenses, glasses, and contacts needed after surgery/accident
> 
> The initial purchase of intraocular lenses, eyeglasses, or contact lenses necessary for the correction of vision and required as a direct result of surgery or an accident where the purchase is made within six months of such accident or surgery.
> 
> ...



I've gone through this already with Sun Life - actually am still going through it with them because when I submitted the receipt from my ophthalmologist for the IOL, they processed the claim as Laser Eye Surgery because the item was listed on the receipt as "multi-focal package".  After I brought their error to their attention, they requested that I provide them with a receipt that specifically identified the expense as being an IOL.  I would suggest that you call Sun Life and explain your situation and ask what would be covered and what the procedure is to have it pre-approved.


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## 06Honda (21 Feb 2020)

Will check with wife on IOL, good advice about calling before hand. Thanks.


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