What is direct billing?
Direct billing means we charge your health insurance provider directly. That means no more paperwork and no waiting to be reimbursed. You simply pay the difference between what your insurance plan covers and the cost of your glasses and eye exam (if there is one).
We offer direct billing for prescription glasses, prescription sunglasses, contact lenses, and eye exams. If we aren’t set up with your insurance provider, we will give you all the required paperwork for you to claim with your insurance company.
If you have an appointment, bring your insurance card and member ID and we will direct bill on your behalf.
If you are purchasing online, you will receive an itemized receipt once your order has been verified and processed, which you can use to submit a claim for reimbursement with your insurance company
What am I covered for?
Many insurance plans and Health Spending Accounts include optical services and products. You can use your benefits to cover your eye exam as well as prescription glasses, prescription sunglasses, and contact lenses.
Just as policies vary between insurers, so do levels of coverage. Each policy has a maximum benefit it will pay, each year, or every other year. Your insurance provider will be able to tell you how much you have to use.
When does vision insurance renew?
Depending on the type of vision plan and Health Spending Account you have, your vision insurance benefits may expire annually. This means any unused benefits from the previous calendar year usually don’t roll over into the new year. Many insurance plans reset with the calendar year (so, your coverage resets on January 1st), but this isn’t true for all plans. Check with your insurance provider to see when your benefits reset to maximize your coverage. You can make a claim at any time of the year.
Milton Optometry is a registered provider with all major health insurers including:
- Avantages sociaux MÉDIC Construction
- Blue Cross Canada
- Canada Life
- Canadian Armed Forces (CAF)
- Canadian Construction Workers Union (C.C.W.U)
- Chambers of Commerce Group Insurance
- Coughlin & Associates Ltd.
- D.A. Townley
- Empire Life
- Equitable Life Insurance Company of Canada
- First Canadian
- GMS Carriers 49 and 50
- Green Shield Canada
- Industrial Alliance
- Interim Federal Health Program (IFHP)
- Johnson Inc
- Johnston Group Inc
- La Capitale/Beneva
- LiUNA Local 183
- LiUNA Local 506
- Manulife Financial
- Maximum Benefit
- People Corporation
- Royal Canadian Mounted Police (RCMP)
- RWAM Insurance Administrators
- SSQ Insurance
- Sun Life
- TELUS Adjudicare
- Union Benefits
- UV Insurance
- Veterans Affairs Canada (VAC)
What is covered by OHIP?
OHIP covers one basic eye exam annually for children aged 19 and younger, and seniors aged 65 and older, subject to certain restrictions. For adults aged 20-64, only those having certain medical conditions are insured by OHIP annually for a basic eye exam, subject to certain restrictions. For an eye exam to be covered by OHIP, all patients must meet the generally applicable eligibility requirements for coverage. Patients not covered by their provincial health care plan must pay for the cost of the eye exam.