Does OHIP Cover Eye Exams in Ontario? A Guide by Age
Click here to learn more on significant changes to how OHIP (Ontario Health Insurance Plan) covers eye exams in Ontario.
Note: This post was originally published on merivalevisioncare.com or wellingtonvisioncare.com. Merivale Vision Care is now Vision Care Merivale and Wellington Vision Care is now Vision Care Wellington, part of Vision Care Ottawa.
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Does OHIP cover eye exams in Ontario?
It depends on your age and health. In short: children and youth 19 and under are covered for one comprehensive eye exam every 12 months; adults 20–64 are covered only if they have a qualifying medical condition; and seniors 65 and over are covered once every 18 months (or every 12 months with a qualifying condition). Here's the full breakdown.
Does OHIP cover eye exams in Ontario? Coverage by age
Children and youth (19 and under)
OHIP covers one comprehensive eye exam every 12 months from an optometrist for anyone 19 and under. Note that OHIP does not cover second opinions, so an examination by a different optometrist to confirm a diagnosis would not be covered.
Adults (20–64)
Routine eye exams are not OHIP-insured for this age group. However, a patient aged 20 to 64 with one of several potentially sight-threatening conditions is eligible for an OHIP-insured comprehensive eye examination once every 12 months. You can see the complete list of qualifying conditions here.
Seniors (65 and over)
A patient aged 65 and over without a qualifying condition is eligible for an OHIP-insured comprehensive eye examination once every 18 months. A patient 65 and over with one or more potentially sight-threatening conditions is eligible once every 12 months. Seniors can also choose to visit their optometrist at any time outside these insured services, though a fee will apply for those appointments.
What changed in September 2023?
These coverage rules took effect on September 1, 2023, following discussions between the Ontario Association of Optometrists and the Ontario Ministry of Health — with the goal of ensuring Ontario residents, especially those at greatest risk of vision loss, have access to OHIP-funded eye care. For more detail, visit the OHIP updates website or read the Ontario Government media release.
Questions about your coverage?
Our knowledgeable, friendly team is always happy to help you understand what OHIP covers and what to expect at your appointment. Bring your health card and we'll handle OHIP billing when it applies. Vision Care Merivale is always here to care for your eyes.
Learn more about our comprehensive eye exams and children's eye care, or book your eye exam online.
Your next step is clear
Whether you need a routine eye exam or specialized care, our team is here for you.