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Are Eye Exams in Canada Covered by the Government?
Posted on January 23rd, 2018
According to the Canadian National Institute for the Blind (CNIB), 75% of all vision loss can be treated or prevented. Unfortunately, many Canadians don't take the time to get a regular eye exam, either because they're worried about the cost or don't think there's anything wrong with their vision (despite the fact that many eye conditions don't have any symptoms until later stages).
But did you know that in many cases eye exams are covered the provincial government, particularly for children and seniors?
Below is a breakdown of the coverage you can expect for each province
(IMPORTANT NOTE: This information may change over time. Also, billings may vary for different optometrists. The best way to find out if you're covered is to contact your local optometrist or provincial health care authority).
- For children (up to the age of 18) and seniors (over the age of 65), a portion of routine annual eye exams are covered as part of B.C.'s Medical Services Plan (MSP).
- Patients of all ages are also covered for other medically required services, such as ocular disease, eye injury and certain diseases related to eye health (for example, diabetes).
- For full details, visit the MSP website.
- Children (up to the age of 19) and seniors (over the age of 65) are covered for one complete eye exam, partial exam, and single diagnostic procedure each year (from July 1 – June 30).
- All patients between the ages of 19-64 are covered for medically necessary conditions, which can include monitoring for diabetes issues, glaucoma and retinal disease, eye injuries (such as a a foreign object in the eye) and post-operative care for cataracts and eye infections.
- For full details, visit the Alberta Health Care Insurance Plan (AHCIP) website.
- Children (under the age of 18) are covered for one eye exam, repeat exam and partial exam per year.
- For patients of all ages, coverage is provided for an initial assessment and follow-up of eye health emergencies (such as an injury).
- Also covered are supplementary health beneficiaries, Family Health Benefits (FHB) beneficiaries, and seniors (65+) receiving a Saskatchewan Income Plan (SIP) supplement.
- For full details, visit the Saskatchewan Provincial Government website.
- Children (under 19 years of age) and Seniors (over the age of 65) are covered for one eye exam every two years.
- Patients between the ages of 19 and 64 are only covered for medically necessary procedures (such as an eye injury).
- For full details, visit the Manitoba Provincial Government website.
- Children (under the age of 20) and seniors (over the age of 65) are covered for an annual eye exam through OHIP.
- Patients between the ages of 19 and 65 are eligible for an eye exam if it is prescribed by a physician or is required for certain eye diseases or disorders.
- For full details, visit the OHIP website.
- Children (up to the age of 17) and seniors (over the age of 65) are eligible for one annual eye exam.
- For patients of all ages, emergency diagnosis is covered, but treatment is not.
- For full details, visit the Quebec Provincial Government website.
- There is currently no provincial coverage available in New Brunswick for eye exams.
- There is however, a social development program called "Healthy Smiles, Clear Vision" that assists children 18 years and under of low income families.
- This program offers a three-year contract that covers eye examination fees, lenses and glasses.
- Coverage is also provided to patients of all ages on social assistance.
- Additionally, yearly comprehensive eye examinations are covered for patients with diabetes.
- For full details, visit the New Brunswick Provincial Government website.
- Children (under the age of 10) and seniors (65 years of age and older) are covered for a complete eye exam once every two years.
- Patients of all ages are covered for health conditions related to eye health (such as diabetes).
- Partial examinations are also covered up to six times per year for the diagnosis and treatment of eye infections, allergies, eye inflammation and the removal of foreign bodies from the eye.
- Additional coverage exists for certain other conditons (such as keratoconus and low vision assessments).
- For full details, visit the Nova Scotia Provincial Government website.
Prince Edward Island
- There is currently no coverage available for eye exams in PEI.
- For full details, visit the Health PEI website.
Newfoundland & Labrador
FYidoctors currently has over 280 locations across Canada. To find out if your next eye exam is covered by your provincial government, contact an FYidoctors near you.