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Insurance Coverage

Will OHIP cover the cost of my eye examination?

One annual eye examination is insured under OHIP for the following age groups:

  • Children age 19 and under

  • Adults age 65+

  • Adults age 20-64 for certain eye and systemic health conditions: Please check with your optometrist to see if you qualify

Additional follow-up and progress visits may be OHIP insured for the above categories; however, costs for additional diagnostic testing and/or treatments are not OHIP covered.

Here is a list of some optometic services NOT covered by OHIP:

  • Additional comprehensive eye exams during the same year of an OHIP-covered exam.

  • Eye examinations that are required by potential employers or other third parties

  • Contact lens fitting exams and progress checks

  • Retinal imaging (such as retinal photography, ocular coherence tomography, Heidelberg retinal tomography, etc)

  • Laser refractive surgery co-management (pre- and post-operative) visits

  • Treatments, such as :

    • Eyeglasses or contact lenses

    • In-office dry eye treatments

    • Vision Therapy (Eye co-ordination exercises)

    • Medications to manage diseases of the eye and surrounding tissues.

Will my private health insurance plan cover the cost of my eye examination?

Routine eye examinations are no longer OHIP insured between the age of 20-64; however, many private health insurance plans will offer coverage for optometry services. Please check with your insurance provider regarding your plan coverage.


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