Additional Information

* OHIP Eligibility

OHIP Eligibility is defined by the Ministry of Health and Long-Term Care. Patients aged 20 to 64 years who have any of the following medical conditions can go to their optometrist or physician and receive an OHIP insured eye examination once every 12 months : diabetes mellitus, glaucoma, cataract, retinal disease, visual field defects, corneal disease, active uveitis or optic pathway disease.

** Additional Follow Up

Additional follow-up and partial eye exams may be required.

*** OCT and Visual Fields

As required. There are no additional fees on our Annual Eye Exams for retinal photos or OCT. OHIP does not cover retinal photos or OCT, which we feel is important to thoroughly examine your eyes for retinal diseases and glaucoma. Early diagnosis and intervention is our goal.

OHIP Covered Conditions

In Ontario, OHIP will cover the cost of an eye examination once every 12 months for patients up to 19 years of age, and once every 18 months for patients over 65 years of age. Patients aged 65 and over with certain medical conditions such as diabetes or glaucoma may be eligible for an OHIP-covered eye exam every 12 months. Full details about OHIP eyecare coverage including a list of eligible medical conditions are available from the Ministry of Health and Long-Term Care website. Patients aged 20 to 64 years who have any of the following medical conditions can go to their optometrist or physician and receive an OHIP insured eye examination once every 12 months: diabetes mellitus, glaucoma, cataract, retinal disease, visual field defects, corneal disease, active uveitis, or optic pathway disease.

Not Covered by OHIP

Routine eye examinations provided by either an optometrist, ophthalmologist or physician, for patients aged 20 to 64, are not covered by OHIP. These individuals are responsible for payment for these examinations or have the cost covered by private insurance.

ODSP, Ontario Works and NIBH

There may be additional fees not covered by these programs. Because of the individual programs we ask that patients contact us before scheduling an appointment. Different programs have different documentation and different coverages. Please contact us and we can help figure out what is required for your situation.

Partial Eye Examinations

Partial eye examinations follow an initial annual assessment and address an issue that has started during the year or to follow-up on an existing condition. The tests required may very depending on the reason for the visit. The fees for a partial eye examination starts from $118 and may be covered by OHIP in some instances.