Service: Ontario Public Drug Programs - Ontario Drug Benefit Program
|Record #: OCR0369||Last Full Update: 20 Oct 2015|
|Office Phone||General inquiry 416-327-8109 * INFOline, Exceptional Access 416-314-5518 * Trillium Drug program 416-642-3038 * Seniors Co-payment information 416-503-4586|
|Toll Free Phone||General inquiry 1-866-811-9893 * INFOline, Exceptional Access 1-866-532-3161 * Trillium Drug program 1-800-575-5386 * Seniors Co-payment information 1-888-405-0405|
|Fax||General inquiry 416-327-8912 * Seniors Co-payment 416-503-8483 * Trillium Drug program 416-642-3034|
|Primary Contact||Rob Campbell, Director, Exceptional Access Program Branch; Phone: 416-327-8109|
|Primary Executive||Suzanne McGurn, Executive Officer/Assistant Deputy Minister; Phone: 416-212-4724; Email: PublicDrugPrgrms.email@example.com|
|Address & Map|
|Description & Services|
|Description (Service)||Through the Ontario Drug Benefit (ODB) Program, the Ministry of Health and Long-Term Care covers most of the cost of 4,300 prescription drug products listed in the ODB Formulary. A person licensed to practice in Ontario must prescribe the medication and the prescription must be filled in Ontario.
Under special circumstances the Exceptional Access Program may cover most of the cost of various other prescription drug products that are not on the Formulary for people in the ODB Program.
The Trillium Drug Program covers individuals and households who have high drug expenses in relation to their income.
The Special Drugs Program provides coverage for certain categories of high cost drugs used in the treatment of specific conditions on an out patient basis in a hospital.
|Hours||Mon-Fri 8:30 am-5 pm|
|Eligibility||People who belong to one of the following groups of Ontario residents and have valid Ontario Health Insurance (OHIP) are eligible for drug coverage under the ODB Program:
65 years of age and older * residents of long-term care facilities * residents of Homes for Special Care * people receiving professional services under the Home Care program * Trillium Drug Program recipients.
People who are receiving social assistance (the Ontario Works program or the Ontario Disability Support Program (ODSP)) are eligible for ODB coverage.
|Application||Seniors are automatically enrolled in the Ontario Drug Benefit program * low income seniors may fill in a co-payment form or they may call the Seniors Co-payment line to have a form mailed out to them|
|Languages||English ; French|
|Fees||None ; ODB eligible people may be asked to pay some portion of their prescription drug product costs.
Single seniors (people aged 65 or older) who have an annual income of $16,018 or more and seniors in couples with a combined annual income of $24,175 or more pay a $100 deductible per senior before they are eligible for drug coverage. After these seniors pay the deductible, they then pay up to $6.11 toward the dispensing fee each time they fill a prescription for a covered drug product in Ontario in the benefit year.
If seniors' income is below the above noted levels, a senior may be eligible for the $2 co-payment plans.
Trillium Drug Program registrants must pay a deductible that is based on their household net income and the number of household members. Deductibles are payable on a quarterly basis and recipients receive benefits after the deductible for the quarter is paid. In the first year of entering the program, there is a pro-rated deductible for households who come into the program part way through the program year. In addition, recipients may be asked to pay up to a maximum of $2 for each prescription.
All other ODB eligible people may be asked to pay up to $2 each time they fill a prescription.
|Legal Status||(30) Provincial Government|
|Established||Public Health Act: 1882; Ministry of Health: 1971; Ministry of Health and Long-Term Care: 1999|
|Print Material||See Website|
|Date Updated||20 Oct 2015|
|Service Categories||Government Subsidized Prescription Drug Benefits|