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Cathleen Wright

 Tags: OHIP+

OHIP+ Changes Coming Into Effect April 2019

As of April 2019, the amendments to the delivery of OHIP+ will come into effect. Originally, OHIP+ was made available to all Ontario residents under 24 years of age who hold a current health card, allowing those with a valid prescription to receive certain medications free of charge.  Under the new provincial government, this program has now been modified to exclude those under 24 years of age who are covered under a private insurance plan – such as a group benefits plan through a parent. In this scenario, the private plan will be the only payer as there will not be the option for coordination of benefits for prescription drugs that were covered under OHIP+.

Those who are not covered under a private plan will still continue to be eligible to participate in the OHIP+ program.

What Are The Advantages Of Being Covered Under A Private Plan vs. OHIP+?

The OHIP+ program has a limited formulary (list of covered prescription drugs) in comparison to a formulary offered under a private plan. To bring this into context, under OHIP+ there is a formulary of over 4,400 drugs that will be eligible for coverage. While that number may seem like a lot, keep in mind that there are over 10,000 drugs NOT covered under this initiative.

Additionally, a private plan may cover key elements including dental, orthodontics and extended coverage options such as prescription vision care, paramedical services, hospital stays, chiropractic/massage and physiotherapy, and medical items. All of those items are not covered under the OHIP+ program as it is strictly for prescriptions.

Where Can I Get More Information?

To learn more about OHIP+ and to review Ontario Drug Benefit Program formulary, visit https://www.ontario.ca/page/learn-about-ohip-plus

View the online formulary for the Ontario Drug Benefit Program at https://www.formulary.health.gov.on.ca/formulary/

Service Ontario general information call centre - 1.866.532.3161 or Toronto 416.314.5518

Specific drug coverage questions - call the Ontario Public Drug Programs at 1.866.811.9893 or Toronto 416.327.8109

Cathleen Wright

With over 30 years of experience, Cathleen possesses an ever-growing knowledge of all aspects of group employee benefits, combined with expertise in the evolving landscape of the insurance industry. She is HIAA and ADR certified, in addition to numerous other professional sales and service certifications. When not working, Cathleen can be found at home watching the Leafs or the Blue Jays, and if it’s summer, she’ll be unplugged at the cottage with a book. Year round yoga is a must to maintain serenity, and a glass of wine or a margarita doesn’t hurt!
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