OHIP

Optometric services covered by OHIP

Effective as of November 1, 2004

You may be eligible for OHIP coverage provided you have a valid OHIP card and satisfy one of the following criteria:

  • Children (0 to 19 years old): one full eye exam (for vision and general eye health) every 12 months, plus any minor assessments required
  • Adults (20 to 64 years) are not covered by OHIP. Exceptions: Adults with certain medical conditions affecting the eyes requires regular monitoring and any follow-up appointments related to the condition. Covered conditions include diabetes, glaucoma, cataract, retinal disease, visual field defects, corneal disease, amblyopia, strabismus, recurrent uveitis or optic pathway disease (a referral or medical note from a doctor may be required)
  • Seniors (65 years and older): one full eye exam (for vision and general eye health) every 12 months, plus any minor assessments required
  • Ontario Disability Support Program (ODSP): one full eye exam (for vision and general eye health) every 24 months, minor assessments are not covered (proof of social assistance is required at each visit)
  • Ontario Works (OW): one full eye exam (for vision and general eye health) every 24 months, minor assessments are not covered (proof of social assistance is required at each visit)

Optometric services not covered by OHIP

(Non-Inclusive)

  • Additional comprehensive eye exams during the same year of an OHIP-covered exam
  • Eye examinations that are required for employment or other third parties
  • Contact lens fitting exams and progress checks
  • Retinal imaging (retinal photography, OCT, HRT, etc.)
  • Laser refractive surgery co-management (pre- and post-operative) visits
  • Treatments: eyeglasses, contact lenses, low vision aids, vision therapy, medications to manage diseases of the eye and surrounding tissues
  • Vision Therapy / Low vision rehabilitation
  • Phone and telehealth consultations
  • Drug prescription renewals outside of office visit
  • Additional copies of the optical prescription
  • No show fees
  • Travel expenses incurred to provide services out of the office