Posted by: The Village Pharmacy
OHIP+ changes come into effect on April 1, 2018
OHIP+ is changing to focus on providing benefits to children and youth without private drug plans. Changes come into effect on April 1, 2019.
If you are currently on OHIP+ and you have private insurance (through your employer, school, parents plan or NIHB), you have until March 31st to fill any new prescriptions or refills under the current OHIP+ plan. Please bring in your prescriptions to The Village Pharmacy as soon as possible.
As of April 1st, you will be required to fill your prescriptions under your private insurance plan, and pay any deductibles.
If you are currently on OHIP+ and you do not have a private drug plan, you will still be covered under OHIP+.
As of April 1st, 2019, OHIP+ provides free prescription medications to youth ages 24 or under who do not have a private drug plan. All you need is a prescription from your doctor and a valid Ontario health card number.
You do not need to apply for OHIP+. If you are 24 years old or younger, do not have a private drug plan (through school, your employer, your parents or through NIHB), and you have a valid Ontario health card, you automatically qualify for free prescription medications, regardless of your income, or your family’s income. You do not pay any dispensing fees, co-payments, deductibles or any other fees out-of-pocket for your prescriptions.
Over 4,400 medications are covered under OHIP+. These are listed in the Ontario Drug Benefit Formulary. They include:
PrEP and HIV medications
antibiotics to treat infections, including STIs
epinephrine auto-injectors (e.g. EPIPENs®)
medications to treat mental health conditions (e.g. antidepressants)
inhalers for asthma
insulin, oral diabetic medications and diabetes test strips
drugs to treat epilepsy and other chronic conditions
attention deficit hyperactivity disorder (ADHD) drugs
drugs to treat some cancers and other rare conditions
The following services are also covered free of charge under OHIP+:
MedsCheck medication review consultation
Pharmacy smoking cessation program
How do I use OHIP+?
Get a prescription from your doctor
Bring in your prescription and your Ontario health card or health card number to your pharmacy
Verify that you do not have coverage through a private drug plan (through school, employer, parents, NIHB)
Your pharmacist will fill your prescription. You do not pay any dispensing fees, co-payments, deductibles or any other fees
Talk to the pharmacist about your medication and collect your prescription.
Refills and Prescription Transfers
If you have a prescription refill on file, it will automatically qualify for OHIP+. Your pharmacist will ask you for your Ontario health card number when you request your refill.
If you are transferring your prescriptions from another pharmacy, please provide your Ontario health card number to your new pharmacy.
I currently have prescription medication coverage through my college / university / employer private drug plan. What happens now?
You are not eligible for OHIP+ as of April 1, 2019. You will be required to fill your prescriptions under your private drug plan and pay any associated co-pays or deductibles. You will need to show your Pay-Direct card or submit a claim to your private insurance provider for any prescription medications you get filled.
I am on OHIP+ What if my medication is not covered by OHIP+?
If you have been prescribed medication that is not covered under OHIP+, you may qualify for coverage under the Exceptional Access Program. Learn more about the Exceptional Access Program here. If you have coverage through a private insurance plan, you can also check with them to see if the drug is covered if you are denied access through the Exceptional Access Program.
I am currently enrolled in the Trillium Drug Program. What happens now?
If you are enrolled in the Trillium Drug Program as an individual and you are 24 years old or under, you will now get all your prescription medications through OHIP+. You will not need to pay any deductibles based on your income. The Ontario Public Drug Programs will contact you before your 25th birthday to enrol in the Trillium Drug Program, so you may continue your medications without interruption.
If you are currently getting coverage for your prescriptions because your family is enrolled in the Trillium Drug Program, your parents will not have to pay any out-of-pocket costs for your prescription medications for everyone 24 years old or younger, though their deductible calculation will stay the same.
Need more info?
For more information on OHIP+ please see these resources:
Email OHIP+ with your questions: OHIPplus@Ontario.ca
Ontario Drug Benefits Formulary - Full listing of drugs covered by Ontario Drug Benefit Program and OHIP+
Apply for OHIP and get an Ontario Health Card online or call Service Ontario at 416.327.7567 in the GTA, 1.800.664.8988 or 1.800.387.5559 (TTY)
Need a doctor for PrEP or HIV? Click here to find clinics specialize in PrEP / HIV.
Download The Village Pharmacy App. You can transfer your prescriptions and upload your prescriptions right in the app. We have all brands of PrEP and HIV meds in stock. PrEP and HIV meds can be shipped to you for free, anywhere in Ontario.