Ontario (ON)
Ontario Health Coverage
Drug Care
Pharmaceuticals - In Hospital
Drugs prescribed and administered by any attending physician.
Pharmaceuticals - Out of Hospital
(or in hospital when visit is solely for the administration
of drugs)
Coverage is available through the Ontario Drug Benefit Program
and Trillium Drug Program.
Ontario Drug Benefit Program
Provides prescribed drugs specifies in the ODB formulary to residents age 65 and over who have been residing in Ontario for at least one year.
- the following individuals will pay $2 for each prescription filled:
- people receiving social assistance
- single seniors earning less than $16,000 per year
- senior couples earning less than $24,000 per year
- residents of nursing homes and homes for the aged
- Home Care recipients
- single seniors earning more than $16,000 per year will pay the first $100 (each individual) for prescriptions and then a maximum $6.11 ODB dispensing fee per prescription.
- senior couples earning more than $24,000 per year will pay the first $100 (each individual) for prescriptions and then a maximum $6.11 ODB dispensing fee per prescription.
Trillium Drug Program
Since April 1, 1995
Eligibility:
Ontario residents must provide financial disclosure of income and individual insurance benefits. Coverage through private plans must be exhausted before benefits are paid through this program.
Covered Expenses:
Prescription drugs included in the Ontario Drug Benefit Formulary (approximately 2,800), plus additional products (approximately 55) subject to a specific physician-requested approval process are covered.
Provides assistance for unmanageable prescription drug expenses.
The annual deductible is paid in four instalments over the Trillium program year (August 1 to July 31 of the following year) and prorated for the portion of the first partial year.
Deductible:
Deductible of $2 for each prescription filled after the annual deductible has been satisfied.
The following sample annual deductibles have been taken from a table of deductibles available from the Ministry of Health.
| Net Income |
Family of One |
Family of Two |
Family of Three |
Family Over Three |
| $6,500 or less |
$350 |
$250 |
$200 |
$150 |
| $14,500 to $15,000 |
$444 |
$344 |
$294 |
$244 |
| $24,500 to $25,000 |
$714 |
$614 |
$564 |
$514 |
| $34,500 to $35,000 |
$1,164 |
$1,064 |
$1,014 |
$964 |
| $49,500 to $50,000 |
$1,839 |
$1,739 |
$1,689 |
$1,639 |
| $64,500 to $65,000 |
$2,514 |
$2,414 |
$2,364 |
$2,314 |
| $79,500 to $80,000 |
$3,189 |
$3,089 |
$3,039 |
$2,989 |
| $99,500 to $100,000 |
$4,089 |
$3,989 |
$3,939 |
$3,889 |
Additional Information:
- Literature is available at most pharmacies in Ontario.
- Hotline: 1-800-575-5386
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