OHIP EYE EXAM COVERAGE

WHAT YOU NEED TO KNOW (AS OF SEPTEMBER 1, 2023)

The Ontario government has updated what's covered under OHIP for eye exams. Here's a simple breakdown by age group:

Children & Youth (19 and under)

  • 1 full eye exam every 12 months

  • Covered for partial exams or follow-ups between regular checkups

Adults (Ages 20–64)

You’re eligible for 1 full eye exam every 12 monthsif you have certain eye or health conditions, including:

  • Diabetes

  • Glaucoma

  • Retinal disease

  • Corneal conditions

  • Optic nerve disorders

  • Uveitis

  • Taking certain medications (e.g. hydroxychloroquine, chloroquine, ethambutol, tamoxifen)

  • Sudden onset of eye misalignment (strabismus) due to injury or disease

  • Advanced cataracts

Follow-up care:

  • Up to 2 partial/follow-up visits per year are covered

  • Additional visits may require payment

Seniors (65 and older)

  • If diagnosed with an eligible eye or health condition (see above):

    • 1 full eye exam every 12 months is covered

  • If no qualifying condition:

    • 1 full eye exam every 18 months is covered

Follow-up care:

  • Up to 2 partial/follow-up visits per year are covered

  • Additional visits may require payment

Please Note:

  • OHIP only covers basic eye exams.

  • Additional tests, scans, or imaging may not be covered. Please bring any Insurance information.

  • Always bring a valid OHIP card to your appointment.

For full details, visit: www.OHIPupdates.ca