Health insurance benefits – have you claimed yours?

Canadians understand the importance of having a regular eye exam. However, many put it off out of concern about the cost. This can lead to serious vision problems being undiagnosed or untreated. An eye exam is often the first step in discovering significant health issues. Patients should see their optometrist as their partner in health care and ensure they are getting regular eye exams to stay on top of their overall health and well-being.

Many employers offer health insurance benefits that cover vision care. This can include an annual eye exam in addition to full or partial coverage for eyeglasses and contact lenses. Your HR department will be able to provide you with resources and information on what your optical insurance coverage will include.

Some Canadians may be left wondering how they access vision care benefits if they don’t have coverage. Vision insurance in Canada differs from region to region, so let’s review how you can ensure that your next eye exam is covered.

Why should I get an eye exam?

You may be asking yourself; do I need an eye exam if I feel fine? The answer is, yes! An eye exam does more than just check your prescription. With the use of highly sophisticated diagnostic equipment, your optometrist can detect serious vision and health issues that left undiagnosed could result in more serious eye complications.

Some of the most common health issues that can be detected during an eye exam are:

  • Heart disease
  • High blood pressure
  • Diabetes
  • Cancer

Getting a regular eye exam allows your optometrist to set milestones, track the progression of any vision health problems, and created a path for treatment.

Does OHIP cover eye exams?

Many Ontario residents qualify for OHIP or the Ontario Health Insurance Plan. The provides coverage for general care like visits to the emergency room. Many Ontarians may not be aware that some basic vision health procedures are also covered under OHIP as long as you meet the requirements.

  • You must be a Canadian citizen or have immigration status as set out in Ontario’s Health Insurance Act.
  • You must have your permanent and main home in Ontario and be physically present in Ontario for 153 days in any 12-month period.

Who is covered by OHIP?

18 and Under

Full coverage for basic eye exams yearly and partial exams as needed.

19 to 64

OHIP covers a wide spectrum of vision health problems, including diabetes, glaucoma, cataracts, retinal disease, amblyopia, visual field defects, corneal disease, strabismus, recurrent uveitis, or optic pathway disease, or with a letter from a registered nurse with extended certificate or doctor.

65 and over

Full coverage for a basic eye exam yearly and partial exams as needed.

How do I know if I have vision insurance in Canada?

Check with your company’s HR department to see what level of optical insurance coverage you have. You may often be able to opt into additional coverage if your company only covers a certain percentage of care. Your partner and children may also be covered under your health insurance benefits.

Do all eyecare providers take insurance?

Most eyecare clinics will take insurance once you provide them with the necessary coverage information. This information then remains on your file for when you attend appointments.

How long does insurance coverage last?

Christmas is a great reminder to use up your remaining health insurance benefits that have to be used up by year-end as they do not carry over.

Contact Us

Book your next eye exam in Belleville, Trenton, Kingston, or Picton, Ontario with Dr. Bruce Coward and Associates, and feel free to contact us if you have any questions about your coverage, or take a look here for more information about direct billing for insurance.