What you should know before getting an eye exam without insurance

November 14, 2014

Getting your eyesight checked when you don’t have insurance coverage may mean you’re paying out of pocket. Here's what you need to know.

It’s true that the rest of the world envies Canada’s healthcare system, and as fortunate as we know we are, there are some frustrating limitations. Eye exams are one of those. Below are some tips on getting an eye exam if you don’t have extended medical insurance.

What you should know before getting an eye exam without insurance

What is covered

Routine eye exams are covered for children, senior citizens and people on social assistance. Details differ slightly per province or territory (i.e., the age of eligibility) so double-check with your provincial medical plan.

Otherwise, eye exams are only covered when medically required, for example, if your doctor believes you have eye disease, trauma, injury or a health condition that will cause risk to the eyes, such as diabetes. You need a doctor’s referral in order for your basic medical plan to cover it.

If you just want to get your eyes checked, change a prescription or just get funky new glasses, you’ll be paying out of pocket unless you have additional medical insurance.

Eye exam costs

The cost of an eye exam varies, depending on where you are getting it done and what is involved in the test. You can get tested at:

  1. An eye doctor’s office.
  2. The eye department of a medical clinic.
  3. Group eye-care practices (optometrists or ophthalmologists).
  4. The optical department of certain big-box retailers.

You can be tested by an optometrist (eye doctor), an ophthalmologist (eye specialist) and sometimes an optician (lens specialist).

Routine eye exams are usually cost from $50 to $100 depending on the test's location.If you're getting an eye exam for contact lenses, expect to pay more as there are different tests and procedures.

When booking your exam, be sure to ask for details on what is included. Some retailers will advertise a low price, but when you get there you might discover you’ll have to pay extra for recommended procedures such as an eye pressure test to rule out glaucoma.

How often to get tested

Most eye care specialists recommend that you have a complete eye exam every one to two years, depending on your age, health and whether you currently wear glasses or contacts.

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