Does OHIP Cover Eye Exams? Everything You Need to Know (2025 Guide)
Does OHIP Cover Eye Exams? Everything You Need to Know (2025 Guide)
Clear vision is essential for everyday life, from reading and driving to working and learning. But eye exams can also detect serious health conditions early, like diabetes, glaucoma, or high blood pressure.
That’s why so many Ontarians ask the same question: Does OHIP cover eye exams?
The answer is: Yes, but it depends on your age, health condition, and exam type. In this post, we’ll break down exactly what OHIP covers, who qualifies for free exams, and how to stay on top of your eye care appointments.
📊 According to Ontario Association of Optometrists (OAO), over 4 million OHIP-insured eye exams are performed annually in Ontario, making up more than 70% of patients at an average practice.
What OHIP Covers for Eye Exams
The Ontario Health Insurance Plan (OHIP) covers eye exams for specific groups of people. Coverage depends on age and certain medical conditions that affect vision.
👶 Children and Youth (0–19 years old)
1 full eye exam every 12 months
Plus any follow-up appointments deemed medically necessary
Covered exam includes vision check, prescription updates, and eye health assessment
👵 Seniors (65+ years old)
1 full eye exam every 12 months
Plus follow-up appointments as needed
Additional tests may be covered if related to specific medical conditions
🧑 Adults with Eligible Medical Conditions (20–64 years old)
OHIP will cover annual eye exams if you have certain eye-related or health conditions, including:
Diabetes
Glaucoma
Cataracts
Retinal disease
Amblyopia ("lazy eye")
Visual field defects
Corneal disease
Strabismus (eye misalignment)
If you don’t have one of these conditions, you’ll likely need to pay out of pocket or use private insurance.
What OHIP Doesn’t Cover
OHIP does not cover:
Routine eye exams for adults aged 20–64 without eligible conditions
Prescription glasses or contact lenses
Laser eye surgery or cosmetic procedures
Advanced diagnostic imaging for non-eligible patients
How Often You Can Get an OHIP-Covered Eye Exam
Children and seniors: once every 12 months
Eligible medical conditions: once every 12 months or more frequently if your doctor recommends it
Emergencies or sudden vision changes may be covered regardless of age.
👉 For the most accurate information, check with your optometrist’s office or the Ontario Ministry of Health.
How to Find an Eye Doctor Who Accepts OHIP
Finding an optometrist who bills OHIP directly can save you from paying upfront.
Steps to find an OHIP-covered eye doctor:
Use the Ontario Association of Optometrists’ directory.
Ask your family doctor or pharmacist for a referral.
Call clinics in your area to confirm OHIP billing.
Ask if they accept walk-ins or require appointments.
Always confirm your OHIP eligibility before booking an appointment.
How to Stay Organized with Eye Health Appointments
Keeping track of your eye health appointments and providers is just as important as understanding your coverage. This is where Syncara, a free personal health record app, can make life much easier.
With Syncara, you can:
👩⚕️ Log and track your eye doctors - save their name, clinic address, phone number, and notes about your care.
📅 Schedule and manage appointments - easily add appointments to Syncara and have them sync to your calendar automatically.
🔔 Set reminders for annual or follow-up eye exams, so you never miss an OHIP-covered visit.
👉 No more lost appointment cards or forgetting your optometrist’s info - it’s all in one secure place.
Next step: Book your next eye exam and keep track of your provider details and appointments in Syncara to make managing your vision care simple and stress-free.
Frequently Asked Questions about OHIP Coverage for Eye Exams
Does OHIP cover eye exams for adults?
OHIP only covers adults 20–64 if they have eligible eye or health conditions such as diabetes, glaucoma, or cataracts.
How often does OHIP cover eye exams for seniors?
Once every 12 months, plus any medically necessary follow-ups.
Does OHIP cover glasses or contact lenses?
No, eyewear is not covered. Many people use private insurance to offset these costs.
Do I need a referral to see an optometrist in Ontario?
No, you can book directly with an eye doctor. Unless it's an eye specialist like Opthamologist, you will likely need a referral.
How can Syncara help with eye care?
Syncara allows you to log your eye doctor’s information, track appointments, and set reminders for OHIP-covered visits.
