A long-term condition is managed on a schedule, not visit by visit. For diabetes that schedule is public, so you can work out for yourself whether a check is overdue.
What the visit covers
- Type 2 diabetes: A1C, cholesterol, eyes and feet on a timetable
- High blood pressure, including the readings you take at home
- Asthma, and the breathing test that tells it apart from COPD
- High cholesterol, and the heart risk that goes with it
- Conditions that need repeat prescriptions and periodic blood work
- Lab requisitions — ask whether yours can be ordered before the follow-up
- Referrals when your numbers stop responding — ask what the clinic can refer you to
Which checks are due, and how often
Ontario sets an interval for four of the type 2 diabetes checks. The fifth, blood pressure, is the one to watch in between.
A1C, your average blood sugar over about three months — at least once every six months.
LDL cholesterol, the bad kind — at least once a year.
A retinal eye examination — at least once a year. An optometrist or an eye doctor does it, so ask for the referral if you do not already have one.
Your feet examined, shoes and socks off — at least once a year.
Blood pressure — Ontario says to monitor it regularly, and the readings you take at home between visits are worth bringing in.
The blood work goes on a lab requisition. Ask whether yours can be ordered before the follow-up, so the numbers are there when you sit down.
If you have been told you have COPD, ask whether you have ever had spirometry: a breathing test that measures how much air you can force out in the first second. Ontario's clinical handbook for COPD says spirometry should be used to confirm all COPD diagnoses, and that overdiagnosis can occur when a diagnosis rests on medical history and physical examination alone. Ask for one rather than waiting to be offered it, and ask where it would be done.
Getting the prescription and paying for it are two different systems. The Trillium Drug Program is for people who have an Ontario health card, do not qualify for the Ontario Drug Benefit, have no plan that pays 100% of their drugs, and spend about 4% or more of after-tax household income on prescriptions. You apply, pay that much as the year's deductible, then up to $2 a drug. The program year is August to July, and reimbursement for the year just ended depends on applying by 30 September.
Ontario also runs free self-management workshops for people living with a long-term condition: six sessions, once a week, two and a half hours each. Ontario.ca sends you to your local home and community care service to find one; that service is now Ontario Health atHome, on 1-833-515-1234.
What OHIP covers
If you have diabetes, OHIP pays for a complete eye examination every 12 months between the ages of 20 and 64, plus two follow-up assessments — an exam other adults that age pay for themselves. A foot assessment is covered; clipping or trimming toenails is not. Blood work that OHIP insures costs you nothing at the lab, though not every test on a requisition is insured, so ask which yours are. The medication is the part OHIP does not pay for at all.
Walk in, or book?
Book it. Going through your numbers, your medication and what changes next takes a full appointment, so ask for one when you call. Walk in when something has turned sharply worse — a chest infection on top of a lung condition, or blood sugar you cannot bring down.
What to bring
- Your health card
- Every medication and inhaler, in the bottles or boxes
- Your home readings, however you keep them — paper is fine
- Your meter, sensor app or pharmacy printout, if you use one
- When and where your last blood work was done, if it was not here
Questions people ask
I keep running out of test strips before the year is out.
The Ontario Drug Benefit covers a fixed number of strips in any 365 days, and the number follows how your diabetes is treated: 3,000 on insulin, 400 on medication with a higher risk of low blood sugar, 200 on medication with a lower risk, and 200 on diet and lifestyle alone. Going past that is a pharmacist override, not a doctor's note, and it needs documentation — the reason, your specific testing frequency, and the name of the provider who recommended it. So bring your meter or its log to the visit: the frequency has to be a number, not a guess. If you use insulin and ODB covers you, a continuous glucose monitor is the other route. Since 31 July 2025 the province funds Dexcom G7 sensors, up to 45 in a 365-day period, for ODB recipients on insulin therapy who hold a valid prescription for them.
I was told I have COPD, but I have never had a breathing test.
Ask for spirometry at your next appointment. Ontario's clinical handbook for COPD calls it the best standardized, objective measurement for airflow limitation and says it should be used to confirm all COPD diagnoses. The same handbook says overdiagnosis can occur when the diagnosis is based only on a person's medical history and physical examination, and that COPD is in many cases assigned on symptoms or clinical intuition without objective confirmation. If yours was, the test is what settles it.
I pay for my own strips and lancets. Is there any help?
There is a program for people with no other funding for the supplies. The Ontario Monitoring for Health Program, funded by the Ministry of Health and administered by Diabetes Canada, reimburses 75% of what lancets and testing strips cost, to a maximum of $920 once every year, and 75% of a blood glucose meter to a maximum of $75 once every five years. It is for Ontario residents who use insulin or who have diabetes while pregnant. Diabetes Canada takes the questions on 1-800-361-0796.
Still have a question? Call the front desk.
Related
- Prescription renewalsBring the bottle or a photo of the label
- Physicals and what Ontario screens forAnnual check-ups and screening by age
- Referrals and lab requisitionsSpecialist referrals and blood work
