OHIP Changes as the Season Phases from Summer to Autumn

Hi friends, Merivale Vision Care here to share some very important changes with you to how OHIP (Ontario Health Insurance Plan) covers eye exams in Ontario. These changes are the outcome of communications between the Ontario Association of Optometrists and the Ontario Ministry of Health with the goal that Ontario residents have access to the best and most current eye care, and that those with greatest risk of vision loss have access to care funded by OHIP. These changes began on September 1, 2023.

The type of OHIP coverage is determined by what age group an Ontario resident lands in. For patients aged 19 years or under, the OHIP coverage for eye examinations remains the same for this age group after September 1st. A patient aged 19 years and under continues to be eligible for an OHIP-insured comprehensive eye exam once per year from an optometrist. Important note: OHIP does not cover second opinions, so an examination by a different optometrist to confirm a diagnosis would not be covered under OHIP.

Beginning September 1, 2023, a patient aged 20 to 64 with one of several potentially sight-threatening conditions is eligible for an OHIP-insured comprehensive eye examination by an optometrist to a maximum of once every 12 months. For the complete list of what potentially sight threatening conditions are covered please visit here.

As of September 1, 2023, a patient aged 65 and over with one or more potentially sight-threatening conditions is eligible for an OHIP-insured comprehensive eye examination once every 12 months from an optometrist. The complete list of what potentially sight threatening conditions are covered is available to view here.

A patient aged 65 and over that does not have a potentially sight-threatening condition is eligible for an OHIP-insured comprehensive eye examination once every 18 months from an optometrist from September 1st. Another important note: a patient aged 65 and over can choose to visit their optometrist for an appointment at any time outside of these insured services and a fee for those appointments will apply.

For more information please visit the OHIP updates website listed above and you can also read the Ontario Government media release about these changes available here. Our knowledgeable and friendly staff are happy to answer any questions you may have about these changes to OHIP coverage so please don’t hesitate to reach out. Merivale Vision Care is always here to care for your eyes.

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