Frequently Asked Questions
  • Which medications are covered?

    OHIP+ completely covers the cost of more than 4,400 drug products that are currently available through the Ontario Drug Benefit program, including:

    • Antibiotics to treat infections
    • Inhalers for asthma
    • Various insulins, oral diabetic medications and diabetes test strips
    • Epinephrine auto-injectors (e.g. EPIPENs®)
    • Medications to treat arthritis, epilepsy and other chronic conditions
    • Antidepressants
    • Attention deficit hyperactivity disorder (ADHD) medications
    • Medications to treat some childhood cancers and other rare conditions

    To find out if your medication is covered through the Ontario Drug Benefit Program visit www.ontario.ca/page/check-medication-coverage/ or ask your Guardian or I.D.A. pharmacist for more information.

    Medications available through the Exceptional Access Program may also be covered if an individual qualifies

  • What about medications not covered under OHIP+?

    If the prescribed medication is not covered by OHIP+, your Guardian or I.D.A. pharmacist may be able to recommend alternative medications that are covered by OHIP+.
    If you have private insurance, some drugs not covered by OHIP+ may be covered by your insurance plan.

    The Exceptional Access Program (EAP) may enable access to some medications for which no appropriate alternative is covered by OHIP+. Your healthcare provider is required to submit a request on your behalf. If approved, the full cost of the medication will be covered. Visit www.ontario.ca/page/applying-exceptional-access-program for more information on EAP.

  • How does OHIP+ affect previously enrolled drug benefits through the Ontario Drug Benefit program?
    Children and youth already enrolled in the Ontario Drug Benefit program will continue to be covered for the same medications. OHIP+ eliminates co-payments and/or an annual deductible. These changes will be automatic.
  • How does OHIP+ affect Trillium Drug Program members?

    If your child is age 24 or under and a member of a Trillium Drug Program household, as of January 1, 2018 they are covered through OHIP+.
    This means, because you don’t pay out-of-pocket for their medications, no money from those medications counts toward your deductible.

    The Ontario government will contact individuals prior to their 25th birthday to ensure those who still need drug coverage enrol in the Trillium Drug Program.

  • My child is currently on a medication that is funded by a private insurance plan. Will my child still be covered under OHIP+?
    If the drug is listed on the Ontario Drug Benefit Formulary/Comparative Drug Index, coverage will be provided through OHIP+.

    If the medication is available through the Exceptional Access Program, your child must qualify for coverage.

    If the drug is not currently funded through the Ontario Drug Benefit program and the Exceptional Access Program, private insurance plan will continue to fund your child’s medication.
  • How do I get an Ontario health card?
    An Ontario health card is required to get OHIP+. For more information on getting an Ontario health card, visit www.ontario.ca/page/health-cards or contact a ServiceOntario Centre at 1-800-268-1154 (toll-free in Ontario only), 416-314-5518 (Toronto and GTA) or 1-800-387-5559 (toll-free TTY).
  • Where can I get additonal resources?

    For general OHIP+ questions or comments, email: OHIPplus@ontario.ca

    To learn more about OHIP+, visit: www.ontario.ca/page/learn-about-ohip-plus

    To learn more about the Ontario Drug Benefit program, visit: www.ontario.ca/drugbenefit