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Are you covered for your eye exam?

OHIP Coverage:

  • Children 19 years old and younger are covered once a year for a full comprehensive eye exam by a Doctor of Optometry, and are also covered for any emergencies within the same clinic. If it has not been a full year since your child's last full eye exam, or a valid health card is not presented you will be expected to pay out of pocket for the exam. 

  • Seniors 65 years old and older are covered once a year for a full comprehensive eye exam by a Doctor of Optometry, and are also covered for any emergencies within the same clinic. If it has not been a full year since your last full eye exam, or a valid health card is not presented you will be expected to pay out of pocket for the exam. 

  • Adults aged 20 to 64 years old are only covered by OHIP for a full comprehensive eye exam with a Doctor of Optometry once a year if they have one of the following conditions: diabetes, glaucoma, cataract, retinal disease, ambloypia, visual field defects, corneal disease, strabismus, recurrent uveitis or optic pathway disease. If it has not been a full year since your last full eye exam, or a valid health card is not presented you will be expected to pay out of pocket for the exam. 

  • Adults aged 20 to 64 years old under ODSP or Ontario Works are covered for one full comprehensive eye exam with a Doctor of Optometry once every 2 years and must present their drug card for the eye exam. 

 

Private Insurance:

  • Most insurance companies will full cover or partially cover an eye exam once every year or two years. You should check with your insurance company to verify your coverage. 

  • We do not bill your insurance directly, we will give you a full receipt that can be submitted to your insurance to receive reimbursement for your eye exam.

 

Fee:

  • The fee for a comprehensive eye exam for an Adult 20 to 64 years old is $70.00. We accept the following forms of payment: cash, debit card, visa and mastercard.