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OHIP Coverage
As of September 1st, 2023, eligibility is changing for OHIP-covered routine eye examinations provided by either your optometrist or physician.
The agreement reached between the Ontario government and the OAO (Ontario Association of Optometrists) will increase access to care for the patients who need it most and are most vulnerable to vision loss.
*There are parts of the examination that are not covered by OHIP. It will be discussed with you prior to scheduling your examination.
Please remember to bring your valid OHIP card every time.
Am I covered?
Patients Aged 19 or Younger
Exam coverage for children is remaining the same. Children are eligible for 1 exam per 12 months.
Yearly examinations are crucial for healthy development. Your child’s vision is an important part of their development and has an impact on their ability to learn and interact with the world.
Patients Aged 20 to 64
*Eligibility for your coverage cannot always be determined prior to your exam, therefore please expect potential fees will be incurred during your visit with your eye doctor.
Yearly eye examinations for patients diagnosed with the above conditions or taking the above medications are necessary for maintaining good eye health and avoiding ocular complications and ocular drug toxicity.
Patients Aged 65 or More
Our doctors recommend maintaining a yearly examination schedule for all seniors. Eyes are important indicators of overall health and wellness. Eyecare goes beyond a prescription for glasses or contact lenses; early detection and preventative measures can help maintain your vision before having any symptoms.
ODSP & OW
Exam coverage for patients on either Ontario Disability Support Program (ODSP) or Ontario Works (OW) remains the same. These patients are eligible for an exam every 24 months.
Covered Conditions:
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Diabetes
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Glaucoma
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Cataract that needs referral or surgery
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Sudden Onset of Retinal Disease
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Corneal Ulcer
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Keratoconus
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Sudden Onset or Progressive Optic Pathway Disease
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Sudden Onset Strabismus (cross-eyed / eye-turn)
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Active Uveitis Flare-Up ONLY
Covered Medications:
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Chloroquine
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Hydroxychloroquine
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Ethambutol
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Tamoxifen
No Longer Covered:
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Stable strabismus & amblyopia (cross-eye & eye-turn)
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Prediabetic
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Glaucoma suspect / narrow angles
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Old, long-standing, or treated retinal condition that is stable
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Cataracts that do not qualify for referral or surgery
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MEE referral forms from your family practitioner are no longer covered.
More coverage questions? Call our team, we are more than happy to help!
