Routine eye examinations provided by either an optometrist or physician, for patients aged 20 to 64, are not covered by OHIP. These individuals are responsible for payment for these examinations or have the cost covered by private insurance.
However, under the Ministry of Community and Social Services (MCSS), persons receiving assistance through the Ontario Disability Support Program, Ontario Works, or the Family Benefits Program will receive coverage for routine eye examinations once every two years. If you have any questions about the coverage provided under these programs, please call Client Services at MCSS at 1 888 789-4199 (toll free) or 416 325-5666 (Toronto) or 1 800 387-5559 (TTY).
- Insured persons aged 20 to 64 years with specified medical conditions affecting the eye can receive an OHIP insured regular eye examination once every 12 months.
- Insured persons aged 20 to 64 with any of the following conditions can go directly to their optometrist or physician to receive an OHIP insured eye examination: diabetes mellitus, glaucoma, cataract, retinal disease, amblyopia, visual field defects, corneal disease, strabismus, recurrent uveitis or optic pathway disease.
- Insured persons aged 20 to 64 who have certain medical conditions not listed above may also be covered for regular eye examinations. They should discuss this with their primary health care provider.