OHIP & INSURANCE • MARCH 2026
By the Optometrists at Avalon Eye Care, Vaughan • 5-minute read
This is one of the most common questions we hear at Avalon Eye Care in Vaughan. The short answer: it depends on your age and your health conditions. Here is the complete 2026 guide to OHIP eye exam coverage in Ontario.
OHIP covers one comprehensive eye exam per calendar year for every Ontario resident aged 19 and under. This is one of the most valuable and underused benefits available to Ontario families.
The Ontario Association of Optometrists recommends children have their first eye exam at 6 months, then at age 2–3, and every year from age 4 onwards. Each of these exams is fully covered by OHIP — your Ontario health card is all you need.
Ontario residents aged 65 and over also receive one OHIP-covered eye exam per year. As we age, the risk of conditions like macular degeneration, glaucoma, cataracts, and diabetic eye disease increases significantly. Annual exams allow early detection when treatment is most effective.
If you are between 20 and 64 and have one of the following conditions, OHIP covers annual eye exams for you as well:
If you have diabetes, this is especially important — diabetic eye exams are fully OHIP-covered and annual exams are strongly recommended by the Canadian Diabetes Association.
Adults aged 20–64 who do not have a qualifying medical condition are not covered by OHIP for routine eye exams. This has been the case in Ontario since the province delisted routine adult eye exams in 2004.
However, you have options:
No — OHIP does not cover eyeglasses or contact lenses for most Ontarians. The Ontario Disability Support Program (ODSP) and Ontario Works (OW) recipients may be eligible for assistance. Private extended health plans typically include an eyewear allowance every 1–2 years.
The only provincial exception is the Eye See Eye Learn program, which provides one free pair of glasses to Junior Kindergarten children who require them.
Whether you are OHIP-covered or not, regular eye exams are an essential investment in your long-term vision health. Avalon Eye Care is located at 200 Whitmore Rd, Unit 15, Woodbridge, and is accepting new patients of all ages.
Call 905-856-3937 or book online today. We offer direct billing to all major insurance plans.
OHIP covers annual eye exams for children 19 and under, adults 65 and over, and adults of any age with certain qualifying medical conditions such as diabetes, glaucoma, or cataracts. Adults aged 20–64 without a qualifying condition are not covered for routine eye exams.
A comprehensive eye exam in Ontario typically costs $100–$150 for adults not covered by OHIP. Many private extended health plans cover eye exams — check your benefits. Avalon Eye Care in Vaughan offers direct insurance billing.
For children 19 and under: once per year. For adults 65 and over: once per year. For adults with qualifying medical conditions: annually, or as medically necessary.
Qualifying conditions for adults 20–64 include diabetes, glaucoma, cataracts, amblyopia (lazy eye), strabismus, retinal disease, and several other medically necessary conditions. Your optometrist will advise if your condition qualifies.
Serving Vaughan & Woodbridge. OHIP & direct insurance billing.
Book Online 905-856-3937