The new year brings changes to Ontario Health Care with OHIP+: Children and Youth Pharmacare, effective January 1, 2018.
OHIP + will provide certain prescription medications for free to children and youth who have OHIP coverage in Ontario and are aged 24 and under. There are no upfront costs for eligible medications, no co-payment or annual deductibles. You do not have to enroll or register, coverage is automatic and stops on the patients 25th birthday.
OHIP + will cover all drugs currently covered through the Ontario Drug Benefit program (OBD). This includes more than 4,400 drug products listed on the Ontario Drug Benefit Formulary. Additional drugs are eligible for funding through the Exceptional Access Program (EAP).
To receive your medication, a valid health card or health card number is required with an eligible prescription from your Doctor or Nurse Practitioner. You can visit any pharmacy in Ontario to have your prescription filled.
OHIP+ becomes the first payor for all eligible drug claims. If OHIP + doesn’t cover the entire cost of the prescription or the medication is not eligible then the cost would be submitted to your private Insurance plan following your normal procedure for submitting expenses.
For more information on the Ontario Drug Benefit Program visit https://www.ontario.ca/page/get-coverage-prescription-drugs
You can access the Medication Coverage Checker to see if a medication is covered under the Ontario Drug Benefit program. https://www.ontario.ca/page/check-medication-coverage