SEE OHIP Updates – Updates to how OHIP covers eye exams in Ontario
WHAT OHIP (Ontario Health Card) COVERS
- basic annual eye exams for seniors (65 and over) with serious eye conditions or diabetes
- basic eye exams for 'healthy' seniors (65 and over) every 18months
- basic annual eye exams for children (19 and younger)
- basic annual eye exams for individuals 20-64 with serious eye conditions or diabetes
- basic annual eye exams for individuals on certain medications with ocular side effects
- for those covered above, TWO RELATED partial eye exams between full assessments
WHAT OHIP DOES NOT COVER
- fitting of contact lenses or the ongoing monitoring of contact lens wearers
- photo documentation
- OCT imaging of retina
- many tests associated with the diagnosis of glaucoma
- visual field testing unless there has been a diagnosis of glaucoma or visual field loss needing monitoring
- red eye / eye infection unless there is a corneal ulcer
- any testing related to MTO/driver’s licenses
- any testing or follow-up related to LASIK or corneal crosslinking eye surgery
- myopia control for children
- glasses or contact lenses
- some partial assessments e.g. over max allowed or unrelated to covered condition
These are the general rules. There are many special cases where OHIP (or another government agency e.g. Veterans or Indian Affairs) may still cover the exam fee. Please chat below or call us at 519-681-3670 to verify.
Related Information on Private Insurance >> Direct Insurance Billing
