In 2004, the Ontario Ministry of Health and Long-Term Care removed OHIP coverage for regular eye examinations for adult patients between the ages of 20 to 64. Only adult patients with certain medical conditions are covered for annual eye examinations under the Schedule of Benefits for Optometry Services.
The Ontario Association of Optometrists (OAO) promotes the importance of regular comprehensive eye examinations. If your eye examination is not covered by OHIP, check your health insurance company’s benefit plan (i.e., Manulife, Sun Life, Green Shield of Canada, Great West Life) for vision care coverage for eye exams, eyewear, and other optometry services. Many employers have extended health-care benefits for employees. OAO encourages you to contact your insurance carrier for further information.
Optometrists can choose to either directly bill a third party insurance provider or the patient. If a patient pays for an insured service, the third party may reimburse all or part of the fee.