Ontario drug programs branch

You are eligible for ODB program benefits if you live in Ontario, you have a valid Ontario health card and at least one of these statements applies to you:. I have high drugs costs relative to my income and am registered in the Trillium Drug Program I receive social assistance through Ontario Works or the Ontario Disability Support Program.

For Seniors Over the Age of On the first day of the month after you turn 65 years of age , take your prescription and health card to your pharmacy. Tell the pharmacist that you are now eligible for the ODB program. Depending on your income, you might be able to pay a lower payment per prescription and avoid the yearly deductible through the Seniors Co-Payment Program.

Manual Reimbursement Process. To receive reimbursement for drugs paid for out-of-pocket, you need to send a letter to the Ministry of Health that includes: — a note explaining that you need a refund. This can take up to 8 weeks. Find out if you qualify for other coverage through:. Some drugs can be purchased without a prescription also called over-the-counter drugs , if you pay for them yourself.

The Ontario Drug Benefit Program may cover the cost of these drugs but only if your physician or nurse practitioner gives you a prescription for them and if the drugs are either:. If you think that the cost of an over-the-counter drug should be covered, check with your healthcare provider before buying the drug to avoid out-of-pocket costs. The Ontario Drug Benefit program covers the cost of nutrition products up to a maximum dollar amount. The product must be your sole source of nutrition and be prescribed by your doctor or nurse practitioner.

Besides writing you a prescription, your doctor or nurse practitioner must fill out a Nutrition Products form for you to receive coverage, stating that the product is the sole source of your nutrition. It also does not cover a nutritional product used for:. If you do not have a doctor who is registered on this list, you will need to be referred to one.

The Ontario Drug Benefit program covers some drugs used in palliative care for example, higher strength narcotic drugs for pain. The drugs must be:. Note that you will also need to consult with a doctor or nurse practitioner who is registered on the Palliative Care Facilitated Access List if you are requesting a high strength opioid through the Exceptional Access Program, including the telephone request service.

When a company develops a new drug, it will have the sole right to make based on a formula and sell the drug under a brand name for a certain period of time.

When the patent ends, other companies are allowed to make and sell their own version of the drug. These are called generics and usually cost less than brand-name drugs, but they are tested and proven to work in the same way. You can get covered for both brand-name and generic drugs , whichever costs less.

But there are exceptions, such as:. In this case, your doctor:. Once filled out by your doctor, take the form and prescription to your pharmacist. Your pharmacist submits the completed form to Health Canada, which monitors drug safety. Some Limited Use drugs are covered for days or weeks, some for a year or years, while some are approved for lifetime coverage. You should also ask your pharmacist to check.

Apply now to make sure you are enrolled before August 1. With the Ontario Drug Benefit program, as a senior someone 65 years or older you pay a portion of prescription-drug costs based on your annual income after deductions and marital status.

You can get coverage as a single senior including as a widowed spouse or as a couple includes spouses who are married, same-sex or common-law partners. We will send you a letter about three months before your 65 th birthday to let you know you will automatically join the Ontario Drug Benefit program. This is a good time to tell your doctor, nurse practitioner and pharmacist so they can plan ahead to make sure that, when needed, you are prescribed one of the more than 5, drugs approved for coverage.

Then, go to your pharmacy on the first day of the month after you turn 65 years old for example, if you turn 65 on April 15, go on May 1.

This is your official start date in the Ontario Drug Benefit program. Only a spouse who is a senior receives drug benefits as a senior. A spouse who is under 65 years can apply to, or remain enrolled in the Trillium Drug Program. For example, if you turned 65 on April 15, your official start date would be May 1. Before this can take effect, you must enrol in the Seniors Co-Payment program by sending a completed application form.

Before this can take effect, you must enrol in the Seniors Co-Payment program by sending a completed Seniors Co-payment Program application form. A spouse who is under 65 years can apply to, or remain enrolled in, the Trillium Drug Program.