As of September 1, 2021 Ontario optometrists may begin withdrawing eye services covered by OHIP after talks with the provincial government broke down over funding for their services. The head of the Ontario Association of Optometrists indicated that optometrists will contact affected patients to cancel appointments and place them on waiting lists.
Who is affected?
The job action only impacts those whose eye services are covered under the provincial health plan, including:
- Patients 19 years and under and 65 years and over who are eligible under OHIP for coverage of one major eye exam every 12 months plus any minor assessments; and
- Patients of any age with certain medical conditions, including glaucoma and retinal disease who receive eye exams covered under OHIP.
Residents of Ontario between the ages of 20 to 64 who aren’t eligible for coverage of eye services under OHIP are not affected. They can continue to receive eye exams from their optometrist and submit eligible claims to their benefits plan.
Can plan members submit expenses to their benefits plan for services impacted by this job action?
No. Ontario plan members or their dependents who are eligible for coverage for eye services under OHIP are not able to submit claims for these services under their benefits plan. Ontario regulation prohibits optometrists from billing direct to the patient, to workplace health insurance, or to individual private insurance for any services provided to those eligible under OHIP.
We will continue to monitor this situation. We will advise of any updates as we become aware of them.