Optical Claim Appeals

Eligibility

If you are concerned about the income used to determine your optical benefits and as a result you were denied funding of an optical claim or were funded less than expected, you may request a review. The review process is as follows:

• First contact the Ministry at the number below for an explanation of the income information used. A review of the income information will be done and an explanation provided.
• If you still disagree with the income used, you must write the director of the Optical Assistance for Seniors program requesting a written review.

Claims

If you have any questions regarding the adjudication of the optical claim or the amount of a payment, contact Alberta Blue Cross at 1-800-661-6995.

If you still disagree with the assessment of the claim, you must write the director responsible for the Optical Assistance for Seniors program. The director will review the claims adjudication by comparing the decision to policies. The director will determine whether it is appropriate to apply discretion in this case.

If you disagree with the decision of the director, you may appeal in writing to the Assistant Deputy Minister.

To contact us: