Learn About OHIP Coverage at Heritage Optometry, Markham

What’s Covered?


Effective September 1, 2023, the Ontario Health Insurance Plan (OHIP) covers the following services provided by your optometrist. You must show your valid health card in order to be entitled to the eye care services being requested.

  • Children ages 0 -19: One full eye examination annually, partial assessments as required.


  • Adults aged 20 - 64 years: One full eye examination annually for people with eligible medical conditions such as diabetes, glaucoma and retinal detachment. It may not be possible to tell if a problem is an insured service until the examination has been completed - eg. The case of a suspected retinal detachment. We advise you to assume that the eye examination is not covered by OHIP; the optometrist will advise you if the condition is insured. Stable conditions such as healed retinal detachment or longstanding strabismus or amblyopia (lazy eye) are no longer covered by OHIP for this age group.


  • Adults 65 and over without eligible medical conditions: One full eye examination every 18 months; two partial assessments as needed between full eye examinations.


  • Adults 65 and over with eligible medical conditions: One full eye examination every 12 months; two partial assessments as needed between full eye examinations


  • ODSP/OWP: one full eye examination every two years.

What is not covered?


Healthy adults between the ages of 20 and 64 are no longer insured under OHIP for comprehensive eye examinations; however, many third party insurers have health care plans in place which do allow vision care coverage. Please check with your insurer to see what is covered in your plan. As well, the following are not covered services under OHIP:
  • Eye examinations for the purpose of completing a report for the ministry for transportation in order to ensure visual acuity and peripheral vision are sufficient to obtain or renew a driver’s license.


  • Additional eye examinations or second opinions.


  • Retinal photography.


  • Contact lens assessments and fittings.


  • Laser Refractive surgery co-management (pre and post-operative) visits.


  • Recommended treatments such as spectacles, contact lenses, low vision aids, vision training, eye medications.


  • Eye examinations for any 3rd party referral. Eg. Fire dept or Police applications.


Similar to what has been done in other provinces, changes have been made to OHIP to prioritize patients with serious, sight threatening conditions like glaucoma, macular degeneration and diabetes.

Call us at our Markham clinic for more information on OHIP, and to book an appointment
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