Skip to main content

We’re located at 5490 Yonge Street, Toronto, ON

eyeexammag
Home » OHIP & INSURANCE

OHIP & INSURANCE

 ohip

Children - 19 years old and younger are OHIP covered for a full eye exam every year

Seniors - 65 years and older are OHIP covered for a a full eye exam every year

Adults - 20 to 64 years of age are no longer eligible for OHIP coverage for their eye examinations (as of November 1, 2004.) However, adults with certain ocular/ medical conditions such as : diabetes, glaucoma, retinal disease, corneal disease, amblyopia, strabismus and visually significant cataracts are OHIP covered for a full eye exam every year. (Diabetic and glaucoma patients must bring their medications or a pharmacy print out list of their medications with them to their eye exam.) Diabetic patients can also choose to have their family physician fax over a referral letter to the office, (FAX: 647-352-5559) in order to obtain OHIP coverage for their eye examination.

ODSP (Ontario Disability Support Program) offers coverage for one full exam every 24 months. Partial eye examinations are not eligible during the 24 month period. [Patients must bring their most recent monthly statement from ODSP and their OHIP (Ontario Health Insurance Card) card in order to be eligible.]

OW (Ontario Works) offers coverage for one full exam every 24 months. Partial eye examinations are not eligible during the 24 month period. (Patients must bring their most recent monthly statement from OW and their OHIP [Ontario Health Insurance Card] card in order to be eligible.)

For further information on coverage please visit Ontario Ministry of Health and Long-Term Care — OHIP coverage for eye care services.

IFHP (Interim Federal Health Program) offers coverage for refugees one full exam every 12 months. Partial eye examinations are also eligible during the 12 month period. Single Vision and Bifocal lenses and frames are covered once every 24 months. (Patients must bring their IFHP documentation.)

............................................................................................................................................................

sunlifegwlbluecrossScreen Shot 2017 12 28 at 6.15.42 PM

 

 

 

Adults - 20 to 64 years old who do not have any of the above conditions, are not covered by OHIP and will have to pay for their eye examination. Most insurance companies will provide coverage for eye examinations as well as for glasses and/or contact lenses. North York Eye Clinic can direct bill for the eye examination and/or glasses/contact lenses to specific insurance providers. Please call your insurance provider and find out what type of coverage you have. Patients can also elect to pay and submit the forms and receipt to their insurance company themselves.

At North York Eye Clinic, we can direct bill for the cost of your eye exam, eyeglasses and contact lenses on your behalf directly to the insurance company. The patient would be responsible for paying any difference/balance remaining. We can direct bill to the following insurance companies:

Microsoft Word CLW I D Card Sample

  • Blue Cross
  • Chambers of Commerce Group Insurance Plan
  • CINUP – Benefits for First Nations
  • Claimsecure
  • Co-Operators Insurance
  • Cowan Insurance Group
  • Desjardins
  • Equitable Life of Canada
  • First Canadian Group of Companies
  • Great West Life
  • Green Shield Canada
  • Industrial Alliance
  • Johnson
  • Johnston Group
  • Manulife
  • Maximum Benefit
  • MDM Insurance
  • Nexgen Rx
  • RWAM Insurance
  • SSQ Financial Group
  • Standards Life
  • Sun Life Financial

Insurance20Companies (2)

*All Manulife and Standard Life plan members must be activated on the plan member site, and signed up for direct deposit and electronic claim statements. If a plan member does not meet these requirements, we will not be able to direct bill for the eye exam and eyeglasses/contact lens fees.

............................................................................................................................................................

education-university-icon-2

University and College Students who attend the following schools have direct coverage through Greenshield insurance:

University of Toronto - Scarborough Campus Only and Part-Time Undergraduate Students. [*University of Toronto - St. George - students must pay first and submit claims to Desjardins Financial Security Life Assurance Company.]

York University / Glendon College/ York University Graduate Students.

Ryerson College (Cont. Ed. Students)

Carlton University Graduate Students/Carlton University Teaching Assistants

University of Ottawa Undergraduate/ University of Ottawa Graduate Students

............................................................................................................................................................

University and College Students who attend the following schools have direct coverage through Sunlife insurance:

Canadian College of Naturopathic Medicine

Queen's University

Sheridan College

University of Waterloo Students/ University of Waterloo Graduate Students

Wilfred Laurier Graduate Students 

............................................................................................................................................................

University and College Students who attend the following schools have direct coverage through Blue Cross insurance:

Seneca College

Wilfred Laurier University

............................................................................................................................................................

University and College Students who attend the following schools have direct coverage through ClaimSecure:

McMaster University

............................................................................................................................................................

University and College Students who attend the following schools have direct coverage through the Campus Trust:

University of Western Ontario

............................................................................................................................................................

UHIP Insurance Coverage

uhip EN UHIP mobile header

North York Eye Clinic will direct bill for patients who have UHIP insurance coverage. UHIP coverage extends only to individuals who are 19 years old or younger. UHIP covers only one eye exam per year and does not have any coverage for eyeglasses/contact lenses.

 

x
Request Appointment