OHIP+ Drug Coverage Age 0-24 (Benefit Tips ® - © 2017)
Beginning in 2018, OHIP+ will cover the cost of most drugs for anyone under the age of 25 without any deductible, coinsurance or income test.
Publicly funded drug programs in Ontario are based on the Ontario Drug Benefit (ODB) formulary which was established in 1970 and covers all Ontarians with deductibles that vary based on their income and circumstances. The ODB covers 4,400 drug products, including some nutrition products and diabetic testing agents. In addition, drugs that are not listed in the Formulary are considered for coverage, on a case-by-case basis, through the Ministry of Health's Exceptional Access Program (EAP).
Benefit Plan Impact:
- Employers can expect their prescription drug claims to reduce by 10% for Ontario staff, reducing overall health care costs by 3% for this group of employees.
- Employees will have fewer claims count against their health spending account or drug insurance maximum and coinsurance if they and/or any of their dependents are younger than age 25. This will free up limited resources that can be reallocated to other benefit priorities.
- Children will have direct access to medication without going through their parent's benefit plan.
- Empowers children and youth to receive the medication they deem necessary directly from the state without regard to family finances, priorities and values.