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Have you claimed your insurance benefits?

Many Canadians may not realize that they can get financial support for their regular exam. This often leads to vision health problems going undiagnosed because patients are avoiding the cost of getting their eyes checked.


Many companies offer health insurance benefits that include vision care. This includes an annual eye exam and coverage for eyeglasses and contact lenses. Patients without coverage have lots of great options too. Private insurance companies offer the same or better coverage than many employers meaning you never have to worry about being able to afford a regular eye exam.


But how do you know which health insurance benefits you have and how to access it? Let’s review some tips and resources so you can ensure that you are getting the maximum coverage for your eye exam.


Why should you have a regular eye exam?

First, let’s start by reviewing why having a regular eye exam is so important. Not only does it detect even the smallest changes in your vision but can also be the first step in identifying more serious eye health problems.


Many patients don’t realize they have underlying health issues until they see their eye doctor. Specialized equipment like retinal imaging can look at the layers of the eye in great detail to detect any abnormalities or health problems including:


● High blood pressure

● Heart disease

● Diabetes

● Glaucoma

● Cancer


An eye exam can also help track the progression of vision health issues so that your eye doctor can prescribe the best line of treatment, which is why being seen regularly becomes a baseline from which your eye doctor can detect changes in your vision and provide the right care options.


Does OHIP cover eye exams?

The Ontario Health Insurance Plan provides coverage for medical care for Ontarians; however, it does not provide vision health care coverage for all residents. To qualify for OHIP coverage, 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.


If you’re aged 18 and under, you can get full coverage for basic eye exams yearly and partial exams as needed.


Anyone aged 19 to 64 can receive full coverage if they have specific vision health care needs 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.


People over the age of 65 get full coverage for a basic eye exam yearly and partial exams as needed.


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

Your workplace’s HR department will be able to tell you what level of insurance coverage you have with your company. If you have a health insurance plan, this usually covers a percentage of prescriptions, vision care and other health issues that may arise. In fact, your vision care benefits will likely cover yourself, your partner, and your children up to a specific age.


Do all vision care providers take insurance?


Most eyecare providers take health insurance benefits. Once you have provided your information, it will remain on file so that you don’t have to worry about providing coverage information when you next visit our optometrists for an eye exam in Ontario.


What do I need to bring to my eye exam?


If you have vision health insurance, then you should bring your coverage card to your next eye exam. This will have your policy number and information about who is covered in your household. Our team will then put this information into your file, where it will be used to submit claim information and provide you receipts that you can submit to your provider.


How long does insurance coverage last?

With Christmas approaching, it may be a good idea to check on your vision health insurance coverage. For most employees, their health insurance benefits must be used by a certain date in the year. If it is not used, then it will renew the following year, and you will lose out on your remaining benefits for the current calendar year.


What if I don’t have insurance?


Eye insurance benefits in Canada vary from province to province. For eye exams in Ontario, there are many private health insurance benefits companies such as Blue Cross that can offer you both health and vision care benefits. You simply pay a monthly fee, like what would be deducted from your pay cheque.


This type of coverage allows you to choose the plan that best suits your specific health and financial needs, and in many cases provides better coverage than what is available at your workplace. You can also purchase private insurance in addition to your workplace coverage. This is particularly helpful for patients with more complex vision health problems.


Contact Us

Contact your local Laurier Optical store for information about what kind of insurance benefits you may qualify for based on your employment and health situation, and to book your eye exam in Ontario at one of our locations. We offer comprehensive eye exams and other eyecare and eyewear services.

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