Eye Exam Maximum

The eye exam maximum is the highest dollar amount your vision or health plan will pay toward the cost of a routine eye examination within a defined period, usually every two years. This benefit encourages preventive eye care by offsetting the cost of visits to an optometrist or ophthalmologist.

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Some plans include eye exams as part of general vision coverage, while others list it separately from eyewear allowances. In certain provinces, seniors and children may already be covered by the government, in which case the private plan coordinates as secondary coverage.

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Example:

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If your plan provides up to $75 every two years for eye exams and your optometrist charges $100, you pay the remaining $25.

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What to Watch For:

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Check how frequently you can claim an eye exam. Plans often specify “every two benefit years,” which may differ from calendar years.