One of the most common questions we hear at Eyeonox is: “Is an optometrist covered by OHIP in Ontario?” The answer depends on your age and health situation. Here’s a clear breakdown so you know exactly what to expect before booking.
Does OHIP Cover Eye Exams in Ontario?
OHIP covers routine eye exams for certain groups only. If you fall outside these groups, you will need to pay out of pocket or use your private benefits plan.
OHIP covers one routine eye exam per year for:
- Children under 20 — annual eye exams are fully covered
- Adults 65 and older — annual eye exams are fully covered
- Adults with specific medical conditions — including diabetes, glaucoma, cataracts, amblyopia, low vision, and certain retinal conditions
Who Is NOT Covered by OHIP?
Adults between the ages of 20 and 64 without a qualifying medical condition are not covered by OHIP for routine eye exams. This group is responsible for the full cost of their exam.
If you’re in this age range, check your employer benefits plan — most extended health plans cover routine eye exams every 12 to 24 months.
What Conditions Qualify for OHIP Coverage?
If you are between 20 and 64, OHIP may still cover your eye exam if you have been diagnosed with one of the following:
- Diabetes
- Glaucoma or a family history of glaucoma
- Cataracts
- Amblyopia (lazy eye)
- Strabismus (crossed eyes)
- Retinal disease
- Low vision
In these cases, OHIP covers one exam per year. Your optometrist may also bill OHIP for additional visits if medically necessary.
Does OHIP Cover Glasses or Contact Lenses?
No — OHIP does not cover the cost of prescription glasses or contact lenses for anyone. These are considered supplementary vision care and must be covered by private insurance or paid out of pocket.
Some employer benefit plans include an eyewear allowance (typically $150–$300 every 1–2 years). Check with your provider for details.
What If I Don’t Have Benefits?
If you are between 20 and 64 and do not have extended health benefits, you will need to pay for your eye exam privately. Contact Eyeonox directly for information on pricing and to book your appointment.
Regular eye exams are still worth the investment — they can catch early signs of serious conditions like glaucoma, macular degeneration, and diabetic eye disease before symptoms appear.
Book an Eye Exam in Brampton
Whether you’re covered by OHIP or paying privately, Eyeonox makes it easy to get the eye care you need. We serve patients of all ages across Brampton, Mississauga, and the Greater Toronto Area.
📍 115 Yellow Avens Blvd Unit #1, Brampton, ON L6R 0M5
📞 905-458-9111
🕐 Monday–Saturday: 10am–8pm | Sunday: 11am–4pm