OHIP Coverage Update
Effective September 1, 2023, we welcomed updates to Ontario’s schedule of billing for routine eye exams. The Ontario government announcement with full details are here: Ontario Eye Care Update - Press Release - September 1, 2023
In summary, what is changing?
Changes for Seniors (aged 65 years or older): Most seniors have previously been covered by OHIP for one eye exam annually. As of September, most seniors will now be eligible for a routine exam once every 18 months. Why the change? Well, if your prescription or overall eye health has been stable over the years and there are no concerns, you might not need to come in more often than that anyway. This leaves room for patients with eligible health conditions, who require more thorough or frequent monitoring, to be seen more promptly.
Important: if you prefer to keep your annual appointment, this can be covered by your personal insurance or direct payment.
Also important: if you have had a vision or health change, this may result in OHIP coverage due to an eligible condition, as determined by your Optometrist during the examination
Changes to Coverage for Eligible Medical Conditions: For those will eligible health conditions (e.g., glaucoma, diabetes, or an acute or worsening disease or condition such as a retinal detachment, macular degeneration, uveitis, or even a tumor), to support the treatment and monitoring of this condition, you are eligible for an OHIP insured routine eye exam.
We aim to help communicate the impact to you personally during your next appointment confirmation, however, sometimes your eligibility can only be determined during your actual eye exam based on our Optometrist’s diagnosis.
As with any big change, it can take some time to fully adapt. If you have any questions or concerns about your eye health, or want to know when you will be eligible for your next eye exam, you can always call or visit our office directly!
“See” you soon :)
