Debates of February 28, 2025 (day 48)

Topics
Statements

Member’s Statement 539-20(1): Extended Benefits Coverage Gaps regarding Optometry

Thank you, Mr. Speaker. Coordination of benefits, many of us know what that means, but for those who don't that means when your work two sets of benefits are working together to get the same ends. We often here this when it comes to dental coverage and prescription coverage and, more particularly, we hear it as in the co-pay system works, 80/20. In other words, one covers 80, then the other one covers the 20.

So as a hypothetical example, Mr. Speaker, with respect to co-benefits -- and I stress hypothetical of course -- let's just say I had to get a prescription to stay as calm and as relaxed as I am as you see here every single day, you know -- you probably think they don't pay enough to keep me calm and relaxed. That said, Mr. Speaker, my submitted prescription -- and, again, this is hypothetical -- my first payer pays 80 percent and my wife's coverage picks up the remainder. But now this is what we're really talking about, the challenges of co-pay benefits.

Now this is a real scenario, not a hypothetical one. Imagine now you're sitting at the ripe age of being a senior. That's in some cases 55 or older, and you need to tap into your benefits for spectacles. And if you're a young person, spectacles mean glasses; you know, the old way of describing them. Mr. Speaker, your spectacles have a theoretic cap on extended health benefits of $300. Now, I'm not against the government saying, through our Blue Cross, going, do you have private insurance. Nothing wrong with that. Hey, let's spend someone else's money, no problem. So that said, the private insurance, if they paid $300, the extended health benefits will say well, we're not paying any more. That seems almost prejudice or bias by not allowing seniors to tap into their benefit.

So imagine, Mr. Speaker, if you have $500 prescription glasses -- and I should stress, in the old days we used to call them Hubbell telescope lenses where they were really thick. But nowadays, they have fantastic technology. If you have a very heavy prescription, they can grind those lenses and make them thin so you look -- they look as normal as possible, Mr. Speaker, which is very important for people's confidence and their ability to do what they need to do.

But those glasses, the extended health benefits says well, if your private insurance is already paid 300 bucks, we're not paying the gap, the difference. Seniors are being denied outright their benefit that they deserve and, as Northerners, they've earned. Mr. Speaker, I'll have questions for the Minister of health to fix this gap because we cover co-pay on dental and prescription. We should do it here too. Thank you, Mr. Speaker.

Speaker: MR. SPEAKER

Thank you, Member from Yellowknife Centre.

Members' statements.