OHIP
Optometric services covered by OHIP
Effective as of September 1, 2023
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)
- Not covered by OHIP. Exceptions: Adults with certain medical conditions affecting the eyes require yearly monitoring plus two minor assessments related to that condition.
- Eligible medical conditions: diabetes, glaucoma, visually significant cataracts, retinal disease, visual field defects, corneal disease, recurrent uveitis, optic pathway disease, ocular toxicity from taking hydroxychloroquine, chloroquine, ethambutol or tamoxifen.
- Not covered by OHIP. Exceptions: Adults with certain medical conditions affecting the eyes require yearly monitoring plus two minor assessments related to that condition.
- Seniors (65 years and older)
- With eligible medical condition: one full eye exam (for vision and general eye health) every 12 months plus two minor assessments
- Without eligible medical condition: one full eye exam (for vision and general eye health) every 18 months plus two minor assessments
- 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)
For further information, please visit the Government of Ontario’s website.
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
- All forms of anterior and posterior segment imaging, including but not limited to: retinal imaging, optical coherence tomography and meibography
- 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
- Additional copies of the optical prescription
- No show fees
- Drug prescription renewals unrelated to an insured service
- Travel expenses incurred to provide services out of the office