The Ministry of Health (MOH) has been working with the Ontario Association of Optometrists (OAO) to implement the new Optometry Services Agreement. The shared goal is to ensure all Ontarians have access to the best, up-to-date eye care available and that patients at greatest risk of vision loss are publicly funded by OHIP.
Effective as of September 1, 2023
optometry services covered by OHIP
You may be eligible for OHIP coverage provided you have a valid OHIP card and satisfy one of the following criteria:
- Children (0 to 19 years old)
- One full eye exam (for vision and general eye health) every 12 months plus any minor assessments required
- Adults (20 to 64 years)
- Not covered by OHIP
- Exceptions: Adults with certain medical conditions affecting the eyes require yearly monitoring plus two minor assessments related to that condition.
- Eligible medical conditions: diabetes, glaucoma, visually significant cataracts, retinal disease, visual field defects, corneal disease, recurrent uveitis, optic pathway disease, ocular toxicity from taking hydroxychloroquine, chloroquine, ethambutol or tamoxifen.
- Seniors (65 years and older)
- With eligible medical condition: one full eye exam (for vision and general eye health) every 12 months plus two minor assessments
- Without eligible medical condition: one full eye exam (for vision and general eye health) every 18 months plus two minor assessments
- Ontario Disability Support Program (ODSP)
- One full eye exam (for vision and general eye health) every 24 months, minor assessments are not covered (proof of social assistance is required at each visit)
- Ontario Works (OW)
- One full eye exam (for vision and general eye health) every 24 months, minor assessments are not covered (proof of social assistance is required at each visit)
optometry services not covered by OHIP
(Non-Inclusive)
- Contact lens exams and progress checks e.g. contact lens prescription
- Pupillary Distance (PD), eyewear measurements & adjustments
- Additional comprehensive eye exams during the same year of an OHIP-covered exam
- Eye examinations that are required for employment or other third parties
- Retinal imaging (retinal photography, OCT, HRT, etc.)
- Myopia control and treatments
- Laser refractive surgery co-management (pre- and post-operative) visits
- Treatments: eyeglasses, contact lenses, low vision aids, vision therapy, medications to manage diseases of the eye and surrounding tissues
- Vision Therapy / Low vision rehabilitation
- Phone and telehealth consultations
- Drug prescription renewals outside of office visit
- Additional copies of the optical prescription
- Late or no show fees
- Travel expenses incurred to provide services out of the office
- Reports, medical notes and release of records
For further information, please visit the Government of Ontario’s website or contact our office for further details.