Are you covered by OHIP?
Patients under the age of 20, over the age of 65 and those with certain medical conditions are eligible for an eye exam covered through their Ontario Health Insurance Plan.
Eye Care Services Not Covered
Routine eye examinations provided by either an optometrist or physician, for patients aged 20 to 64, are not covered by OHIP. These individuals are responsible for payment for these examinations or have the cost covered by private insurance.
However, under the Ministry of Community and Social Services (MCSS), persons receiving assistance through the Ontario Disability Support Program, Ontario Works, or the Family Benefits Program will receive coverage for routine eye examinations once every two years. If you have any questions, please contact us.
Eye Care Services Covered
- People 65 years and older and those younger than 20, are covered by OHIP for a routine eye examination provided by either an optometrist or physician once every 12 months plus any follow-up assessments that may be required.
- Specified ophthalmology services for patients of any age with specified medical conditions or diseases affecting the eyes are insured.
- Insured persons aged 20 to 64 years with specified medical conditions affecting the eye can receive an OHIP insured regular eye examination once every 12 months.
- Insured persons aged 20 to 64 with any of the following conditions can go directly to their optometrist or physician to receive an OHIP insured eye examination: diabetes mellitus, glaucoma, cataract, retinal disease, amblyopia, visual field defects, corneal disease, strabismus, recurrent uveitis or optic pathway disease.
- Insured persons aged 20 to 64 who have certain medical conditions not listed above may also be covered for regular eye examinations. They should discuss this with their primary health care provider.
For more information please visit https://www.ontario.ca/page/what-ohip-covers