What Does an eye exam Cost?

Thorough Eye Exams are more than the determination of a prescription for eye glasses.

A thorough and comprehensive eye exam can begin at $ 145 depending on the determination of extent of coverage.

Ocular Health assessments should include, Refractive (eyeglass Rx) Visual sensory assessments, Binocular vision and focusing assessments, as well as a dialated Ocular health assessment of the eye, eye lids, and internal structures of the eye including Laser enhanced imaging such as OCT microscopic imaging.  The thorough ocular health assessment may have some portions determined to be covered by OHIP however the determination can only be determined when the examination is in process or complete.

Does OHIP Cover Eye Exams?

For some patients in certain age groups, it does, although there are some optometrist services that OHIP may not cover for everyone.

– Children 0 to 19 years old: An annual, full comprehensive eye examination plus any follow-up assessments that may be required.
– Seniors aged 65 +: An annual, full comprehensive eye examination plus any follow-up assessments that may be required.
– Adults aged 20 to 64 years: OHIP does not cover comprehensive eye examinations for this age group. These individuals have private insurance coverage or pay out-of-pocket.”

When Does OHIP Cover Eye Exams?

OHIP covers comprehensive eye exams for patients once a year. Any extra eye exams during the same year usually need the patient to pay out-of-pocket or through their private insurance. While comprehensive eye exams are covered once a year for seniors and those 19 years old and younger, a few optometrist services are not covered. Those services usually include:

  • Contact lens fitting exams and progress checks are also typically not covered.
    – Some eye tests like retinal imaging (retinal photography, ocular coherence tomography) are also not usually covered.
    – Low vision aids
    – Vision Therapy (Eye coordination exercises)
    – Medications to manage diseases of the eye and surrounding tissues