Government of New Brunswick

Overview

The Ocular Prosthesis Program provides funding to enable New Brunswick residents who have lost one or both eyes, or have gross scarring deformity, to have access to the services of a qualified ocularist.

Only amounts that are not eligible for coverage by any other federal, provincial or third-party program or private insurance plan, will be reimbursed.

To determine if you qualify for reimbursement, fill in, print, and send the Ocular Prosthesis Application Form and required supporting documents to the mailing address provided on the form.

Only the costs related to services provided on or after March 1, 2018 are eligible for reimbursement.

Eligibility

To qualify for funding, an applicant must:

  • be a full time New Brunswick resident and be eligible for Medicare under the Medical Services Payment Act; and
  • in the opinion of a qualified medical practitioner, require the use of a conventional ocular prosthetic procedure or component.

Note: New patients and those requiring early replacement must be referred to a certified ocularist by an ophthalmologist or family physician. A referral is not required for routine replacement or repairs.

Description

The program will provide up to 80 per cent of the cost of eligible services (to a maximum amount listed in the program’s tariff), which include:

  • supply and fitting and provision of artificial eyes or scleral cover shells when prescribed by a qualified physician;
  • replacement of the prosthesis once every five years for adults and once every two years for others up to the end of the month of their 19th birthday, or earlier if determined by an ophthalmologist or a family physician;
  • any repair, buildup, re-veining, resurfacing, and re-polishing of the prosthesis required, as determined by a qualified ocularist or the patient’s family physician;
  • house or hospital calls, covering the time from leaving the office to the time of return to the office; and
  • other services as approved at the discretion of the Department on a case-by-case basis.


Consult the Ocular Prosthesis Program Tariff under the Forms section for the maximum reimbursement amount for ocular prosthesis related services rendered in New Brunswick.

Please call the toll free number 1-844-443-3172 for any inquiries. Voicemail messages will be returned within three business days. Alternatively, you can email your questions to Health.Program.Coordinator@gnb.ca

Note: Services received outside of New Brunswick are eligible for reimbursement only on a case-by-case basis with a prior approval from this Department. Travel and accommodation expenses are the responsibility of the patient.