Visiting the optometrist should be a smooth and stress-free experience—especially when it comes to understanding insurance coverage and what to expect at your appointment.
At Junction Optometrists, we want our patients to feel informed and prepared before they arrive. Here’s everything you need to know about insurance, payment options, and what to bring with you for your visit.
Do We Direct Bill? Here’s What You Need to Know
When it comes to insurance, we only direct bill Blue Cross. If you have another insurance provider, we’ll provide you with a detailed invoice so you can submit the claim yourself for reimbursement.
Many of our patients find this process simple, but we always recommend checking with your insurance provider in advance to confirm your coverage details.
OHIP Coverage: Who Qualifies?
For patients with Ontario Health Insurance Plan (OHIP) coverage, here’s what you need to know:
✔️ Children (Under 20) and Seniors (65+) – Covered for a routine eye exam once every 12 months.
✔️ Adults (20-64) – OHIP does not cover routine eye exams unless you have a qualifying medical condition such as diabetes, glaucoma, or certain other eye diseases.
If you’re unsure whether you qualify for OHIP-covered eye care, bring your health card, and we’ll check your eligibility during your visit.
What to Bring to Your Appointment
To ensure a smooth check-in process, be sure to bring:
- Your health card (if applicable for OHIP coverage).
- Your insurance details (if submitting for reimbursement).
- Your current glasses or contact lenses (so we can assess your current prescription).
- A list of any medications you take (as some can affect eye health).
We also recommend arriving 10 minutes early to allow time for preliminary testing and file updates.
Understanding Your Responsibility: Checking Your Coverage
Before your appointment, it’s always a good idea to check with your insurance provider to confirm what is covered under your plan. Since we don’t verify individual policies in advance, patients are responsible for ensuring their insurance covers their visit.
Some key questions to ask your insurance provider:
✔️ Is my eye exam covered?
✔️ If so, how often can I claim for an exam?
✔️ Are there any restrictions on coverage for glasses or contact lenses?
✔️ Do I need a referral for an optometrist visit to be covered?
If you’re paying out of pocket, we’ll provide you with a clear and itemized receipt so you can submit it to your insurance company if applicable.
Investing in Your Eye Health
Regular eye exams are an essential part of maintaining good vision and overall health. Even if your insurance doesn’t cover your visit, investing in a comprehensive eye exam is one of the best things you can do to protect your eyesight.
Our team at Junction Optometrists provides thorough assessments to detect changes in vision, early signs of eye disease, and overall eye health.
Questions? We’re Happy to Help!
If you have any questions about insurance, payment options, or what to expect at your appointment, feel free to give us a call at 437-529-5317. Our team is happy to assist in making your visit as smooth and stress-free as possible.
Looking forward to seeing you soon!