OHIP+ offers youth access to free prescription meds

New program makes prescriptions free for patients under 25.

As of Jan. 1 2018, OHIP+ covers 100% of prescription Ontario Drug Benefit (ODB) formulary drug costs for those under age 25. Eligible drugs will be paid at 100% coinsurance, with no out-of-pocket expense for the claimant. Patients only need a valid OHIP card and an eligible prescription.

Not sure if a drug is covered by OHIP or OHIP+? Search for it online using the Ontario Ministry of Health’s new check medication coverage tool.

For prescription drugs that qualify under the Exceptional Access Program (EAP), the prescribing physician must apply on behalf of the patient. Co-operators plan members or dependents under 25 who were being reimbursed for an EAP drug before Jan. 1 have received a letter from us advising them to see their physician to apply for EAP coverage through OHIP+. If they received a letter of decline from the Ontario Ministry of Health (MOH), they can submit their claims and the letter of decline to us for consideration under their EHC prescription drug plan parameters.

Anticipating a large influx of EAP applications, private insurers and the MOH have worked together to transition some EAP drugs, such as antibiotics, blood thinners, and those with low approval rates. Private insurance plans will continue to cover these drugs without a MOH letter of decline until June 30, 2018.

If you have questions about these changes, or how they impact your group benefit plan, contact our Group Client Service Centre at 1-800-667-8164 between 8 a.m. and 8 p.m. EST Monday to Friday.