The Ontario Health Insurance Plan (OHIP) covers a range of medical services that have been deemed necessary. A small portion of this coverage includes vision care. Within this vision-care portion, vision therapy isn’t included.
OHIP currently considers vision therapy to be more of a rehabilitative service, which is why this service isn’t covered by OHIP.
Understanding Vision Therapy
Contrary to its name, vision therapy isn’t only about building or strengthening eye muscles. This therapy aims to improve communication between the eyes and brain by utilizing neuroplasticity, the brain’s ability to reorganize itself by forming new neural connections.
As humans, we have binocular vision. That is, we have two eyes that are meant to work together. Each of our two eyes has a very slightly different field of vision, from a slightly different perspective. When binocular vision is healthy, the brain can use the difference in information to determine distances and coordinate eye movement.
Vision therapy aims to help with any problems in binocular vision, including focusing as well as how the eyes work together as a team.
One key piece of information to keep in mind is that vision isn’t innate, but a learned skill. With vision therapy, an individual may be able to gain or improve their visual skills, thereby improving their binocular vision.
The purpose of vision therapy is to enhance the brain’s communication with the eyes by using visual exercises that aim to realign and strengthen the eye muscles. These exercises include:
- Ocular movement
- Eye accommodation
- Binocular vision
- Visual processing
All of these skills are necessary for good depth perception, tracking, and adjusting focus.
Vision therapy goes beyond simple visual exercises and incorporates tools like prism lenses, filters, and eye patches to bolster visual abilities. There are distinct visual skills crucial for clear vision, and a deficiency in any of these can lead to issues that affect quality of life.
While some visual exercises can be performed at home, they aren’t replacements for professional visual therapy provided by an eye care specialist in this field. Visual therapy is tailored to an individual’s specific needs.
Typically, sessions with a VT optometrist and vision therapist occur once or twice a week in-office, lasting around 50 minutes.
During a session, patients will focus on practicing progressive exercises or procedures under supervision from their optometrist or vision therapist. Therapy can become all the more entertaining when we utilize gamified training with virtual reality. At the end of the session, patients can expect to have homework exercises to perform at home. Consistency with visits is key to improving vision.
The program can range from a few weeks to a year, depending on the individual’s visual issues, age, and dedication to the prescribed exercises and materials. Ultimately, your optometrist will set the timeline. Although each patient and situation is unique, noticeable results typically appear within a few weeks to six months.
Because our brains are wired to be able to learn new skills, there’s no age limit for vision therapy. It’s effective for children and adults. Children can begin vision therapy as young as three years, provided they have the attention span and language skills necessary for these sessions.
Understanding OHIP
As vision therapy can be beneficial for those who need to strengthen their binocular vision, many people are curious whether vision therapy is covered under the Ontario Health Insurance Plan (OHIP).
The Ontario Health Insurance Plan (OHIP) is a provincial-run healthcare program that provides coverage for a range of essential medical services to residents of Ontario. OHIP aims to provide all eligible residents access to necessary healthcare without direct charges.
OHIP plays a small role in covering specific eye exams and treatments.
Who Qualifies for OHIP?
Not everyone currently living in the province of Ontario may be covered under the provincial healthcare plan. To qualify for OHIP individuals must meet all the following qualifications:
- Be a Canadian citizen or permanent resident.
- Physically reside in Ontario for at least 153 days in any 12-month period.
- Physically be in Ontario for at least 153 days of the 183 days immediately after you move to this province
- Make Ontario your primary residence
Those who meet these criteria but have not yet applied can apply online, in person at their local ServiceOntario center, or by mail. Applicants must present proof of identity, residency, and citizenship or immigration status during the application process.
OHIP doesn’t cover routine eye exams for adults aged 20 to 64, unless there are certain medical or eye diseases that are potentially sight threatening. OHIP covers basic eye examinations for ages 19 and under, or 65 and older. Some diagnostic tests that are recommended by your eye doctors may not be covered by OHIP, but are recommended in early detection of eye conditions as healthcare strives to be preventative rather than reactive.
Coverage for Vision Therapy Under OHIP
Unfortunately, OHIP doesn’t cover vision therapy, as it’s classified as a rehabilitative service rather than a medically necessary treatment. While some assessments by optometrists may be covered, the subsequent therapy itself usually falls outside of OHIP’s purview.
Based on the selected program and details of the plan, private insurance coverage may provide some reimbursement for portions of the treatment. However, this varies significantly. It’s strongly advised that patients thoroughly discuss the details of their vision coverage with their insurance provider and explore if any coverage includes vision therapy.
A letter from your optometrist that emphasizes the importance of vision therapy can be a valuable piece of supporting documentation when seeking alternative funding sources like private healthcare, employer benefits, or specialized grants for treatments.
Unfortunately, OHIP doesn’t alter its coverage based on these recommendations. The policy is set at a provincial level and applies uniformly, meaning endorsements from healthcare providers don’t influence what’s covered by the plan.
Schedule a Consult
For those interested in seeking vision therapy, knowing whether OHIP covers this treatment may influence their decision to use it. Unfortunately, OHIP only covers a small portion of vision care, which doesn’t include vision therapy.
Nonetheless, the importance of vision therapy cannot be understated. Connect with our team at Foresee Eyecare to schedule your vision therapy consultation.
