Ontario Optometrists are reimbursed at the lowest rate in Canada … and it’s not even close

Source: OAO pamphlet

The worst in the country

Optometrists in Ontario have known for quite some time that the government funding here for exams was bad, and the public is now becoming much more aware of this fact too.

Funding models

There are 3 main ways to approach optometry funding, and each province can chose to go about it slightly differently:

  • No government funding for eye care — The costs are paid completely by the patient, regardless of their age (used in places like Saskatchewan or some of the Atlantic provinces, with exceptions for certain populations)
  • Partial government funding (“Balance billing”) — A portion of the exam is paid by the province, and the patient is charged the rest (done in BC). They could then use private insurance they may have to cover the rest
  • Total government funding (at least for some populations) — Patients who are covered can get an exam without paying anything out of pocket
Charts created by the OAO to show the difference in funding models between provinces

Quebec

For our neighbours, provincial optometric coverage recently went through its own set of changes in 2018.

Manitoba

Making our way out west, the population eligible for coverage is much the same as Ontario:

Alberta

In what looks to be the best funded eye care system, the government covers the same types of populations (kids, seniors, some adults), but pay out a much better base amount ($80.70), as well as separate coverage for the dilated exam portion (when applicable).

Something has to change

It’s not hard to see that the situation in Ontario is bad.

  • Exams are reimbursed for less than cost in Ontario
  • That fee is far below the equivalent of any other province

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Patrick Monaghan

Patrick Monaghan

Dad to 2 kids on the spectrum. Autism Advocate.