Current as of October 2026. Government programs, tax rules and prices change. Check the official sources listed at the end of this page before making a decision, and confirm details with a licensed advisor.
What OHIP leaves for you to pay
As of October 2026, Ontario's health insurance plan does not cover routine care in a regular dental office; it covers only certain dental surgery done in hospital. Prescription drugs you fill at a community pharmacy, such as an antibiotic from your family doctor, are also outside OHIP for most working-age adults.
Eye exams follow age rules as of October 2026. OHIP covers a yearly major eye exam for people 19 and under, and one every 18 months for people 65 and over. Adults aged 20 to 64 are covered only if they have an eligible medical condition, such as diabetes or certain types of glaucoma. Publicly funded physiotherapy is limited to certain groups, such as people 19 and under, people 65 and over, and those recently discharged from hospital. For the full picture, see what OHIP does not cover.
Dental costs
Dental is usually the biggest out-of-pocket surprise, because one cracked tooth can turn a checkup into a much larger bill. Prices vary by clinic, by the dentist's fees and by how complex the work is. These guides explain what drives each one:
- Dental cleaning cost in Ontario
- Root canal cost in Ontario
- Dental crown cost in Ontario
- Dental implant cost in Ontario
- Braces cost in Ontario

Vision, hearing and medical devices
Frames, lenses and contacts are a recurring cost for many families. Hearing aids and custom orthotics can be significant one-time purchases. As of October 2026, Ontario's Assistive Devices Program pays 75% of the approved price for eligible devices for Ontario residents with a physical disability that requires the device for six months or longer, so the remaining 25%, plus any optional extras, is still yours to cover (people on certain social assistance programs may have more covered). Learn more about the Assistive Devices Program.
- Eye exam cost in Ontario
- Glasses cost in Ontario
- Contact lenses cost in Ontario
- Hearing aids cost in Ontario
- Orthotics cost in Ontario
Therapy, paramedical care and prescriptions
A sore back after a weekend of yard work, a stressful season at work, a new daily medication: these are the costs that add up quietly over a year. Session prices depend on the practitioner, the length of the visit and where you live. Prescription costs depend on the drug and the pharmacy's dispensing fee. As of October 2026, OHIP+ covers eligible drugs for people 24 and under who are not covered by a private plan, and the Trillium Drug Program can help households whose prescription drug costs are high compared to their household income.
- How much therapy costs in Ontario
- Massage therapy cost in Ontario
- Physiotherapy cost in Ontario
- Chiropractor cost in Ontario
- Prescription drug costs in Ontario
How a group plan changes the math
A group benefits plan typically reimburses part or all of eligible costs up to set limits, so a crown or a pair of glasses becomes a smaller, more predictable expense. Coverage levels, annual maximums and covered services vary by plan, which is why reading the schedule matters more than the plan name. Common building blocks include group dental coverage, extended health benefits for drugs, vision and paramedical care, and a health spending account for flexible top-ups.
Employer coverage also interacts with government programs. As of October 2026, people with access to dental coverage through an employer plan, including a health spending account that covers dental, are not eligible for the Canadian Dental Care Plan. If you run a business and want to offer your team real help with these costs, you can get matched with a licensed benefits advisor who can explain options that fit your budget.
Common questions
Does OHIP cover dental care for adults?
As of October 2026, OHIP does not cover routine care in a dental office. It covers only certain dental surgery performed in a hospital.
Are eye exams free in Ontario?
As of October 2026, OHIP covers eye exams for people 19 and under and 65 and over, and for adults 20 to 64 only with an eligible medical condition. Other adults usually pay for routine exams themselves or through benefits.
Can an employer plan affect eligibility for government dental coverage?
Yes. As of October 2026, having access to private dental coverage, including through an employer plan or a health spending account that covers dental, makes a person ineligible for the Canadian Dental Care Plan.
Sources and further reading
- Government of Ontario: What OHIP covers
- Government of Ontario: Get coverage for prescription drugs
- Government of Ontario: Get physiotherapy
- Government of Ontario: Get help with high prescription drug costs
- Government of Ontario: Assistive Devices Program
- Government of Canada: Canadian Dental Care Plan, do you qualify
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