Nichani P, Trope GE, Buys YM, Markowitz SN, El-Defrawy SR, Ngo G, Markowitz M, Jin YP
CMAJ Open, 9(1)E224-E232
Publication year: 2021

Abstract

Background: Insurance coverage may reduce cost barriers to obtain vision correction. We determined the frequency and source of prescription eyewear insurance to understand how Canadians finance optical correction.

Methods: Insurance data from Ontario respondents to the Canadian Community Health Survey in 2003, 2005, and 2013/14 was analyzed. Unadjusted proportions and adjusted prevalence ratios (APR) of having insurance were compared.

Results: Insurance covered all or part of the costs of prescription eyewear for 62% of Ontarians in all survey years (n=42,777 in 2003, 41,766 in 2005, and 42,553 in 2013/2014). Among those insured, 84-86% had employer-sponsored coverage, 9-10% from government-sponsorship, and 6-7% via private plans. In 2005 and 2013/14, employer-sponsored coverage remained at 87% for individuals in households with post-secondary graduation, but decreased significantly for those in households without secondary school graduation, from 67.0% (95% confidence interval [CI] 63.2-70.8%, 175,000 individuals) in 2005 to 54.6% (95% CI 50.1-59.2%, 123,500 individuals) in 2013/14. Government-sponsored coverage increased significantly for individuals in households without secondary school graduation, from 29.2% (95% CI 26-33%, 76,400 individuals) in 2005 to 41.7% (95% CI 37-46%, 93,900 individuals) in 2013/14. Ontarians in households without secondary school graduation (versus those with) were less likely to report employer-sponsored coverage (APR 0.79, 95% CI 0.75-0.84), but more likely to have government-sponsored coverage (APR 1.27, 95% CI 1.06-1.53).

Interpretation: 62% of Ontarians had prescription eyewear insurance. The largest source of insurance was employer-sponsored, primarily covering those with higher levels of education. In recent years, government-sponsored insurance increased significantly among less-educated individuals.