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Ministry Status: Activation Status

OHIP+: Children and Youth Pharmacare

OHIP+ Stakeholder E–blast

Patients First

Update: OHIP+ Children and Youth Pharmacare Program

July 6, 2017

Colleagues,

We are pleased to share this update on OHIP+: Children and Youth Pharmacare Program (OHIP+) with you.

You can count on regular OHIP+ emails like this as your source of ongoing information and updates. We encourage you to share them with staff members, local stakeholders and other clinicians, and colleagues.

Minister’s Message:

Canadians have long cherished our universal, publicly funded health care system. It is a part of our national identity, rooted in the belief that all Canadians should have access to medical services, regardless of ability to pay.

Yet, while we are providing more patients with access to a health care provider, too often, we are failing them – particularly our most vulnerable – when it comes to prescription medications.  In order to achieve truly universal health care, we need to ensure they have access to the medications that they need.

Starting on January 1, 2018, Ontario is going to take a bold, historic step toward realizing this goal with the creation of OHIP+: Children and Youth Pharmacare Program.

OHIP+ will make Ontario the first province in Canada to provide universal, first dollar prescription drug coverage to everyone age 24 years and younger, regardless of their family income.  This program will benefit over 4 million children and youth, covering 100% of the cost of over 4,400 drug products – the entire Ontario Drug Benefit Formulary. There will be no annual deductible and no co-payments. All that’s needed is a valid prescription and an Ontario health card number.

Ontario is blazing a new path with this program, the most significant expansion of medicare in the province since its creation 50 years ago. I will continue to champion universal pharmacare, working to identify new opportunities to continue to expand prescription drug coverage for all Ontarians.

[original signed by]

Honourable Eric Hoskins, Minister of Health and Long-Term Care


How will OHIP+: Children and Youth Pharmacare coverage work?

All children and youth aged 24 and under who have OHIP+ coverage will automatically be enrolled in OHIP+. OHIP+ coverage will stop on an individual’s twenty-fifth birthday. The new OHIP+ program will cover all drugs and drug products currently reimbursed through the Ontario Drug Benefit (ODB) program. This includes more than 4,400 drug products listed on the ODB Formulary/Comparative Drug Index and additional drugs eligible for funding through the Exceptional Access Program (EAP).

This will include medications to treat:

  • asthma
  • depression
  • anxiety
  • attention deficit hyperactivity disorder (ADHD)
  • infections (e.g. antibiotics)
  • epilepsy
  • diabetes (including test strips)
  • reproductive health (e.g. oral contraceptives)
  • some childhood cancers and rare diseases

Starting January 1, 2018, if a child or youth aged 24 or under requires an eligible medication, they or their caregiver can bring their valid prescription and health card number to a pharmacy and will receive that medication at no cost. Enrollment in OHIP+ will be automatic for children and youth with OHIP+ eligibility. There will be no out of pocket costs (i.e. deductibles or co-payments).

What is not covered by OHIP+ Children and Youth Pharmacare:

Drug products that are not available through the ODB program will not be covered.

More Updates Coming

You can expect regular updates like this as we move forward together.

Please Stay in Touch

Visit us online at www.ontario.ca/OHIPplus

We value your feedback. If you have questions or comments, please email us at OHIPplus@ontario.ca

To automatically receive these updates, join our mailing list by emailing OHIPplus@ontario.ca

This document is available in alternate formats upon request.


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