Glasses

If a client meets all qualifications, an Advance Payment of Benefit for optical goods and services (collectively known as glasses) may be made.

There is a preferred supplier arrangement in place for glasses.

If a client resides in an urban area covered by a preferred supplier agreement for glasses then the client must use a preferred supplier.

If a client resides in an urban area with a preferred supplier for glasses and refuses to purchase from a preferred supplier, their application for an Advance Payment of Benefit must be declined.

If a client resides in a non-coverage area they have the option to use a non-preferred supplier or they can travel to a preferred supplier at their own cost.

Some clients have high clinical needs which means the glasses they require cannot be provided at the standard contract price. Hardship assistance for a higher amount than the standard package amount can be provided for clients with high clinical needs.

Some types of high clinical needs are:

• vision which is outside of 'normal' ranges (+ or - 6 or higher)
• severe astigmatism that requires a special lens grind
• growths on eyes due to severe UV exposure
• some forms of medication make eyes very sensitive to light and glasses require a special coating
• prescription for glasses that are heavy and a higher grade of progressive lenses that are required to avoid frames buckling or the weight tearing the clients skin

Lens coatings or glasses specifically for Irlen Syndrome are not covered by MSD or the Ministry of Health.

Whaikaha provide a Spectacle Subsidy for children 15 years and younger with vision problems.

The subsidy is paid for each qualifying child up to $287.50 (including GST) and can be accessed annually.

To qualify either the child or parent/guardian must have a Community Services Card or the child must have a High Use Health Card.

The subsidy covers the eye exam, frames, lenses, eye patches and repairs.

There is also an additional amount of $51.11 (including GST) available for children who need adult sized frames if the child's vision is changing quickly or if they have an amblyopia (lazy eye) or strabismus (squint).

There is no discretion to top-up the Ministry of Health subsidy unless the full subsidy has been claimed within the 1-year period and the child has a high clinical need.

Then a client can apply for hardship assistance for their child through MSD.

These are processed using the preferred supplier arrangement.