March 29, 2019

OHIP+ Changes

The end of free prescriptions
 
In 2018, the then Liberal Ontario government announced a new OHIP program called OHIP+.  It covered approximately 4,400 drugs for Ontario youth up to age 25.   The plan provided full coverage for these prescriptions regardless if your child had access to a group benefit plan through your employer’s plan or not.
 
When the Ontario PC party came to power last summer, one of their first announcements was to change the OHIP+ plan so that it took second payer status but did not provide a timeline. They have since announced that effective April 1, 2019, the OHIP+ program will only cover youth who do not have access to any private plan such as that offered by your employer or association. 
 
What does this mean for you?
Under OHIP+ 100% of the cost of prescriptions were covered by the government.  As of April 1st, youth with access to a private plan will no longer be covered by OHIP+.  A “private plan” includes an employer-sponsored, student, or individual plan, and Health Care Spending Accounts.
 
Depending on how your plan is structured, you may incur some out of pocket expenses for deductibles, dispensing fees, co-insurance, or uninsured drugs.  These expenses are not eligible to claim through OHIP+.  Individuals or families with high out of pocket drug costs may qualify for financial support through the Ontario Trillium Drug Program.
 
Most group plans cover dependent children up to age 21.  If they are a full-time student, they are typically covered up to age 25 (check your employee handbook to verify the details of your unique policy). 
 
 
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