Starting January 1st, 2018, the Government of Ontario will offer expanded drug benefits for children and youth. Under the new OHIP+: Children and Youth Pharmacare program, Ontario Drug Benefit (ODB) drugs will be fully covered, regardless of family income or student status.
In anticipation of these changes, we’ve compiled a few commonly asked questions:
Who Is Eligible?
Children and youth under the age of 25 who have a valid OHIP card will be covered under the new program, regardless of income, family status, or school enrollment. Coverage ends once the individual turns 25.
How Do You Register?
There’s no need to sign up. The guardian or individual simply presents the prescription recipient’s health card at the pharmacy when they pick up the medication.
What Drugs Are Covered?
Over 4,400 drugs are 100% covered through the OHIP+ program, including allergens such as Epi-pens, certain diabetes supplies, and some prescribed over-the-counter medications. Certain specialty drugs may be reimbursed through the Exceptional Access Program (EAP). Eligible individuals can also check their medication coverage online.
With these new changes, plan members who are under 25 or who have dependent children under 25 will enjoy greater coverage through OHIP+, resulting in fewer claims and increased benefits. This new program will help take some of the burden off of benefits plans as the cost of prescription drugs continues to rise. Any reduction in plan usage will be reflected in future group renewals.
If you have questions about how this new program may affect your clients or employees, feel free to reach out to us.
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