The Ontario Health Insurance Plan was designed to provide for basic care for vulnerable populations.
OHIP does not pay for any new technology such as OCT and digital photography, not because they are unnecessary but because OHIP has limited funding targeted towards the most critical eye diseases. The OHIP definitions and fee structures changed for the first time in 30 years on September 1, 2023.
Our practice prides itself in investing in technology to provide the most up-to-date care for our patients. Each person’s vision journey is important; Dr. Yeomans sees you as an individual deserving of the best care available.
OHIP Coverage By Age Group
Currently, OHIP provides funding for:
Children birth to 19 years old: An annual eye examination and any follow-up assessments that may be required.
Seniors aged 65 +: A complete eye examination every 18 months and two minor assessments during that time.
Adults aged 20 to 64 years: OHIP does not cover eye examinations for this age group except for some specific medical conditions.
Medical Conditions
Seniors (65+) and adults (20-64) diagnosed with diabetes, glaucoma, visually significant cataract, macular degeneration, acute corneal disease, uveitis, drug toxicity, acute retinal detachment at the time of the examination, are covered for an annual examination and two minor examinations, with some exceptions.
Not OHIP Covered
- Additional refractive eye exams during the same year of an OHIP-covered exam.
- Additional assessments beyond the two eligible minor assessments per coverage period.
- Visual field testing except for diagnosed glaucoma patients and some very specific other patients
- Eye examinations that are required by potential employers or other third parties such as the Ministry of Transportation.
- Retinal imaging or scanning; new technology.
- Laser refractive surgery or co-management.
- Treatments, such as eyeglasses, contact lenses, low vision aids, vision therapy or medications to manage diseases of the eye and surrounding tissues.