OHIP COVERAGE

OHIP (Ontario Health Card) Coverage

Depending on your age and residence, your eye exam may be eligible for health card coverage. Want to know if you are covered? Please refer to below for a better understanding of your coverage or if your eye exam will require a fee.

The table below shows coverage, and requirements for coverage, under OHIP:

* Exceptions apply

 

In Ontario, the following exceptions apply for coverage under OHIP (Ontario Health Insurance Plan):   

 

  • Diabetic patients, who are taking medications or referred by their family doctor, are covered by OHIP annually, and are strongly advised to have annual eye examinations to monitor for any visual and ocular manifestations.

 

  • OHIP provides coverage for patients between the ages of 20-64 years old with ocular conditions. If referred by a family physician, patients are required to provide a signed Major Eye Examination form (MEE). Patients who qualify for a major eye exam (ages 20-64) include those with conditions such as Glaucoma, visually significant cataracts, Corneal disease, Retinal disease, Amblyopia and Strabismus.

 

Coverage under Other Governmental Programs

Outside of OHIP, the following programs may also assist patients with coverage for eye examinations:

 

  • The ODSP – Ontario Disability Support Program provides coverage for one comprehensive eye exam every 24 months. Proper proof of documentation is required.

 

  • The OW – Ontario Works program provides coverage for one comprehensive eye exam every 24 months. Proper proof of documentation is required.

     

     

     

     

     

     

     

     

     

Insurance Coverage

You may also be eligible for coverage of eye examinations through your company’s employee benefits plan.

 

If you are attending University or College, you may be enrolled in a medical benefits package that includes coverage for eye examinations.