Learn how to get help paying for prescription drugs in Ontario.

There are a few programs in Ontario that can help you paying for your prescribed medication. These programs are separate from the Ontario Health Insurance Plan (OHIP). OHIP pays doctors and other health care providers to provide certain health services.

If you qualify, Ontario’s drug programs will pay most of the cost of some of your prescription drugs. Each program has its own rules about who can be qualified. However, there are two prerequisites for every one of them:

  1. you must live in Ontario
  2. you must have a valid Ontario Health Card

The Ontario Drug Benefit is for residents of the province only. Make sure your health card is valid (e.g. hasn’t expired). Your pharmacist will need it to confirm your Ontario Drug Benefit eligibility and submit a claim to the ministry.

Ontario Drug Benefit eligibility

You will qualify for the Ontario Drug Benefit when you turn 65 years old. For seniors, Ontario Ministry of Health and Long-Term Care will send you a letter three months before your 65th birthday.

You will be qualified for the Ontario Drug Benefit before you reach your 65, if you are:

  • living in a long-term care home or a home for special care, or
  • enrolled in one of these programs: Home Care, Ontario Works, Ontario Disability Support Program, or Trillium Drug Program

To be covered by the Ontario Drug Benefit, the prescription must be filled in a pharmacy in the province.

What is covered

The Ontario Drug Benefit covers most of the cost of more than 4,400 prescription drug products. It helps you pay for:

  • allergy shots and Epipen (used in response to severe allergic reaction)
  • some products used in monitoring and testing for diabetes
  • some prescribed over-the-counter drugs under specific circumstances (e.g. Ibuprofen 200mg, Ferrous sulphate 300)
  • some nutrition products
  • some drugs used in treatment of HIV/AIDS
  • some drugs used in palliative care

What is not covered

The following will not be covered by the Ontario Drug Benefit:

  • prescription drugs that you buy outside Ontario
  • drugs that are not listed on the Ontario Drug Benefit Formulary, or are not approved for the Exceptional Access Program

Here are some resources where you can get detailed information about Ontario Drug Benefit Formulary and brand-name vs. generic drugs; fill out co-payment application for seniors and apply for the benefits; how to get a 3-month supply or coverage during travel and much more:

(Visited 1,434 times, 1 visits today)