The Ontario Drug Benefit Program—ODB for short—is designed to help people pay for costly drugs purchased in Ontario. Many people struggle to afford the price of their drugs, and few may not realize that the province offers substantial assistance.
If you have an Ontario Health Card and buy your drugs from a pharmacy or doctor registered to the ministry’s Health Network System, you may be able to significantly reduce those costly medical payments. Continue reading below to see if you meet the program’s requirements, and click here to check out the program’s formulary—an index of all drugs covered.
In very particular instances, the program may cover drugs outside of the formulary, such as when a drug in the ODB list is tried but does not work. OBD may also cover allergy injections, diabetic testing, some doctor-suggested nutrition products, and some over-the-counter drugs.
You’re 65 or Older
In the weeks before you turn 65, you’ll receive a letter in the mail telling you that you’re about to qualify for the Ontario Drug Benefit Program. You’ll be automatically registered the day after your 65th birthday; all you need to do is go to the pharmacy with your prescription and let them know you’re now eligible. Seniors can generally expect to pay a $100 deductible each year (the first year will be prorated, depending on when your birthday falls in relation to the benefit year’s August 1st start date), and a “co-payment” each time their prescription is filled (a maximum of $6.11).
You Live in a Long-Term Care Home
If you live in an assisted living facility or nursing home, you will likely be accepted for the Ontario Drug Benefit Program, too. Contact your Community Care Access Centre to see what can be arranged.
You’re Enrolled in the Home Care Program
If you have health services that support you directly in your home, you also may be eligible for the Ontario Drug Benefit Program. As with those in assisted living facilities and nursing homes, your local Community Care Access Centre will help set you up.
Your Drugs Are Expensive and Your Income Can’t Keep Up
If you’re not already qualified under the senior, home care, or social assistance categories, you may qualify for the Trillium Drug Program (TDP)—note that there is a special application if you are both a senior and have insufficient income. People who qualify for the TDP will pay a set deductible each year, usually around 4% of their household’s combined net income, and a subsequent $2 for each prescription they have filled. You can get the application form at the local pharmacy, by calling 1-800-575-5386, or by downloading it here.
You Receive Qualifying Social Assistance
If you receive help from Ontario Works, a program that offers financial and employment assistance to those who are unable to meet basic living expenses, or the Ontario Disability Support Program, which offers financial assistance and benefits to those with a disability, you are likely eligible for Ontario Drug Benefits as well.
What If You’re Traveling?
By giving a letter or travel insurance document to your pharmacist before going on a lengthy trip, you may be able to receive a travel supply of up to 200 days. If you have less than 30 days of your drug on-hand, the ministry can arrange to pay for up to 200 days of extra medicine. If you have over 30 days, they can pay for 100. If you receive Ontario Works support, they can pay for 35 and if you’re part of the Trillium Drug Program, you may be eligible for various amounts, although not between February 1st and July 31st.