OHIP Eye Exam Coverage, Age Benefits,
and Insurance Partners
At Bright Eyes Optometry, we make it easy to understand OHIP coverage and insurance options for your eye care. Whether you’re a child, adult with an eligible condition, or a senior, our guide explains how often eye exams are covered and what conditions qualify. We also work with a variety of insurance partners to ensure your vision care is accessible and convenient.
In Ontario, the Ontario Health Insurance Plan (OHIP) provides coverage for eye exams based on age and specific medical conditions.
Here is an overview of the current coverage.
Children and youth 19 years old or younger:
- 1 eye exam every 12 months
If you are 20 years old or older, and you have an eligible medical condition affecting your eyes, OHIP will cover:
- 1 eye exam every 12 months
Eligible medical conditions are:
- diabetes mellitus
- glaucoma requiring or having had treatment with medication, laser (excluding prophylactic laser peripheral iridotomy), or surgery
- cataracts / posterior capsular opacification with a visual acuity of 20/40 or worse in the best corrected eye, or when a surgery referral is made
- retinal disease that is acute, or is chronically progressive
- corneal disease that is acute, or is chronically progressive
- uveitis that is acute or chronic during episodes of active inflammation
- optic pathway disease that is acute, or is chronically progressive
- acquired cranial nerve palsy resulting in strabismus during the acute phase or until the condition resolves or stabilizes
- ocular drug toxicity screening for patients taking hydroxychloroquine, chloroquine, ethambutol or tamoxifen
If you are 65 years and older and you do not have an eligible medical condition affecting your eyes, OHIP will cover:
- 1 eye exam every 18 months
Insurance Partners
We support Direct Insurance Billing!