OHIP and Insurance Coverage

Georgian Optometry > OHIP and Insurance Coverage

OHIP and Insurance Coverage

Direct Insurance Billing:

We bill directly to most plans of the following insurance companies:

Canada Life
Sun Life Financial
Green Shield Group Benefits Insurance
Manulife
Claim Secure
Blue Cross
IA Financial_Group
Nexgenrx
Empire Life
Standard Life
Great West Life
Blue Cross
GSC
The Co-operations
Manulife Financial
Cowan

Call our office for the specific information required by each plan to bill to your insurance provider directly. For those plans we cannot bill directly, we are pleased to assist you fill your insurance forms. We carry vision care benefit insurance forms from the following companies for your convenience:

Claim Secure
Desjardins
Nexgenrx
Chambers of Commerce Group Insurance Plan
OTIP RAFQ

OHIP Coverage:

The Ontario Health Insurance Plan (OHIP) offers the following coverage for eye examinations for those with valid OHIP cards. A valid OHIP card must be presented at the time of examination to receive vision care benefits.

0 to 19 years of age:

One full examination per twelve (12) month period and any necessary follow up examinations within the same twelve month period once the full examination has taken place.

65 years and above:

One full examination per twelve (12) month period and any necessary follow up examinations within the same twelve month period once the full examination has taken place.

20 to 64 years of age:

As of November 2004, the OHIP no longer provides benefits for eye examinations to patients inthis age group unless the patient fits into specific categories of eye disease outlined by the ministry of health. The determination of coverage takes place during the eye examination depending on the presence of these specific disorders.

Diabetic Patients:

One full examination per twelve (12) month period regardless of age. All necessary follow up examination are also covered during the same twelve month period once the full examination has taken place. Proof of diabetic status must be presented at the time of examination. Accepted documentation for proof of diabetes is an official pharmacy list or a note from the family doctor or treating physician/nurse practitioner.

Ontario Works (OW) and Ontario Disability Support Program (ODSP):

One full examination per twenty four month (24) period. Necessary follow up examinations are not covered through OHIP. A valid Ministry of Community and Social Services Drug Card must be presented as proof of OW and ODSP at the time of examination.