OHIP+ Is Changing April 1st, 2019

The changes affect OHIP-insured children and youth aged 24 and under, including those:

  • without a private plan, who will remain eligible for OHIP+ without co-payments or deductibles
  • with a private plan, who will no longer be eligible for OHIP+ and will access prescribed medicines through their private plan

OHIP+ makes more than 4,400 drug products free for anyone age 24 years or younger. You don’t need to enroll – all you need is a health card number and an eligible prescription.

Who is covered

All babies, children and youth age 24 years and under who have OHIP coverage are automatically covered by OHIP+: Children and Youth Pharmacare. You do not have to enroll or register to access OHIP+ – coverage is automatic. OHIP+ coverage will stop on your 25th birthday, but you may qualify for other financial help with prescription drug costs.

What is covered

OHIP+ completely covers the cost of more than 4,400 drug products that are currently available through the Ontario Drug Benefit program, including:

  • antibiotics to treat infections
  • inhalers for asthma
  • various insulins, oral diabetic medications and diabetes test strips
  • epinephrine auto-injectors (e.g. EPIPENs®)
  • drugs to treat arthritis, epilepsy and other chronic conditions
  • medications to treat mental health conditions (e.g. antidepressants)
  • attention deficit hyperactivity disorder (ADHD) drugs
  • drugs to treat some childhood cancers and other rare conditions
  • help to quit smoking:

Medications available through the Exceptional Access Program may also be covered if an individual qualifies.

How to get your medication

If you’re a parent

If your child is 24 years old or under and needs a covered medication:

  1. Visit your child’s doctor or nurse practitioner and get their prescription.
  2. Take their health card OR health card number to any pharmacy in Ontario – you don’t need a separate or special card.
  3. The pharmacy will fill their prescription at no charge – you don’t pay a dispensing fee, deductible or co-payment.

If you’re 24 years old or under

If you need a covered medication:

  1. Visit your doctor or nurse practitioner and get your prescription.
  2. Take your health card OR health card number to any pharmacy in Ontario – you don’t need a separate or special card.
  3. The pharmacy will fill your prescription at no charge – you don’t pay a dispensing fee, deductible or co-payment.

How OHIP+ affects other coverage

Insurance plans

If you have a child eligible for OHIP+, as of January 1, 2018, OHIP+ is the first payer for eligible drug products.

Trillium Drug Program members

If your child is age 24 or under and a member of a Trillium Drug Program household, as of January 1, 2018 they are covered through OHIP+. This means, because you don’t pay out-of-pocket for their medications, no money from those medications counts toward your deductible.

Students going to university/college in another province

If you’re going to university or college in another province, your prescriptions may still be covered by OHIP+ if you:

  1. remain insured by OHIP
  2. have a valid prescription
  3. get your medications from a pharmacy in Ontario

You may be able to get a larger “travel supply” of your medication before leaving Ontario.

For more information visit: https://www.ontario.ca/page/learn-about-ohip-plus


Want to learn more? Let’s Talk!

To receive additional information on OHIP+ and how it may impact your business, please contact your benefits consultant at at 1-800-661-1518 or fill out the contact form below.

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