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Diabetes

Health Coverage

Maintaining a healthy weight is very important in managing type 2 diabetes. Doing so will help control your blood glucose, blood pressure and blood fat levels. A healthy weight can also help to reduce the risk of complications such as heart disease and stroke, and simply makes you feel better, with more energy!


Eye Care Services

Coverage provider :  Ontario Health Insurance Plan (OHIP)


Who qualifies?  Patients 65 years of age and older and patients 19 years of age and younger.

For what supplies?  One routine eye examination every 12 months and any required follow-up assessments.


Who qualifies?  Patients age 20 to 64 with any of the following conditions: diabetes, glaucoma, cataract, retinal disease, amblyopia, visual field defects, corneal disease and strabismus.

For what supplies?  Major eye examination by an optometrist or physician every 12 months and any necessary follow-up assessments.


Who qualifies?  Patients of all ages.

For what supplies?  Medically necessary eye care services provided by physicians.


Contact :

Prescription Drugs and Supplies

Coverage provider #1 :  Ontario Drug Benefit Plan (ODB), Ministry of Health and Long-Term Care

Who qualifies?  Patients on a provincial social assistance program and those who are 65 years of age or older.

For what supplies?  Diabetes supplies including most types of insulin, oral medications (hypoglycemics), and blood testing strips.

Note :
If you are 65 years of age or older, are using the ODB and have an annual income of $16,018 or more (or a combined income of $24,175 or more for a couple), you will have to pay an annual deductible of $100 up front. After that, you will pay up to $6.11 per prescription. If your annual income is under $16,018 or $24,175 for a couple, no up-front payment will be required and you will pay a $2 prescription fee.

Products listed on the ODB Formulary for diabetes are :

  • Oral antidiabetic agents
  • Insulins
  • Testing strips

Contact :


Coverage provider #2 :  Trillium Drug Program, Ministry of Health and Long-Term Care

Who qualifies?  Patients whose drug costs are high compared to their annual income. You will need to make an up-front payment, broken up into four parts over the year, to access the program. This payment is based on a review of your household income.

For what supplies?  Diabetes supplies including most types of insulin, oral medications (hypoglycemics), and blood testing strips.

Contact :


Coverage provider #3 :  Assistive Devices Program (ADP), Ministry of Health and Long-Term Care

Who qualifies?  Patients 65 years of age or older who use insulin by injection on a daily basis.

For what supplies?  Annual grant of $170, paid once per year, for the purchase of needles and syringes used to inject insulin.

Who qualifies?  Children, youth and adults with type 1 diabetes who meet the program’s medical eligibility criteria. You must be assessed and followed up by an ADP-registered Diabetes Education Program.

Patients who continue to qualify will have to show that they meet the eligibility criteria.

For what supplies?

  • 100 % of the cost of an insulin pump listed with the program, which must be sold to the patient at the ADP-approved price of $6,300.
  • Funding for insulin pumps can be renewed every five years, if the pump is no longer in good working order.
  • An annual grant of $2,400 for related supplies, paid out in four equal payments ($600 each) directly to the patient or their legal agent. The grant must be used to buy supplies needed to make the pump work and must be renewed on a yearly basis.

Contact :


Coverage provider #4 :  Assistive Devices Program (ADP), administered by the Canadian Diabetes Association, Ministry of Health and Long-Term Care

Who qualifies?  Eligible patients who use insulin or have gestational diabetes.

For what supplies?

  • 75 % of the cost of a blood glucose monitor up to $75, or 75 % of the cost of a talking blood glucose monitor up to $300. Patients can access this funding once every five years.
  • 75 % of the cost of lancets and testing strips up to $820 annually.

Contact :

Canadian Diabetes Association : 1-800-361-0796


Dietitians

Registered dietitians working in a Diabetes Education Program in acute care and community care settings are covered by OHIP. Private insurance coverage may cover the cost of visiting a registered dietitian in private practice.

To determine if you have coverage for the services of a registered dietitian working in private practice, contact your insurance provider. To locate a Diabetes Education Program or a registered dietitian working in private practice, call the number or visit the website listed below.

Contact :

Foot Care

Coverage provider :  Ontario Health Insurance Plan (OHIP)

Who qualifies?  Residents of Ontario

For what supplies?  Assessments personally performed by physicians for all aspects of diabetes care, including assessment of feet. OHIP does not pay for services such as the clipping or trimming of toenails.

Contact :  ServiceOntario: 1-800-268-1154 (toll-free in Ontario only). In Toronto: 416-314-5518

For More Information

Call ServiceOntario, Infoline at 1-866-532-3161
In Toronto, 416-314-5518
TTY 1-800-387-5559
In Toronto, TTY 416-327-4282
Hours of operation : 8:30am - 5:00pm