Ontario Drug Benefit (ODB)
Through the Ontario Drug Benefit Program, the Ministry of Health and Long-Term Care covers most of the cost of prescription drug products listed in the Ontario Drug Benefit (ODB) Formulary. If you belong to one of the following groups of Ontario residents and you have valid Ontario Health Insurance (OHIP), you are eligible for drug coverage under the ODB Program :
- people 65 years of age and older;
- residents of long-term care facilities;
- residents of Homes for Special Care;
- people receiving professional services under the Home Care program;
- Trillium Drug Program recipients.
In addition, if you are receiving social assistance (the Ontario Works
program or the Ontario Disability Support Program (ODSP)), you are eligible for ODB coverage.
What drugs are covered?
As long as the drug products are prescribed by an authorized Ontario prescriber, the ODB Program covers :
- approximately 3,000 quality-assured prescription drug products;
- a number of limited-use drug products;
- some nutritional products;
- some diabetic testing products.
Where may the drugs be purchased?
The ODB Program automatically pays for the above listed drug products for people eligible for ODB coverage if the drugs are purchased :
- in an Ontario pharmacy that is on-line with the ministry's Health Network; or
- from an Ontario doctor licensed to sell prescription drug products.
Does ODB cover all of the costs?
ODB eligible people may be asked to pay some portion of their prescription drug product costs.
Single seniors (people aged 65 or older) who have an annual income of $16,018 or more and seniors in couples with a combined annual income of $24,175 or more pay a $100 deductible per senior before they are eligible for drug coverage. After these seniors pay the deductible, they then pay up to $6.11 toward the dispensing fee each time they fill a prescription for a covered drug product in Ontario in the benefit year.
All other ODB eligible people, including Trillium Drug Program recipients, may be asked to pay up to $2 each time they fill a prescription. Trillium Drug Program applicants must also pay a quarterly or prorated deductible that is based on their income before they are eligible to receive drug coverage.
The benefit year for all ODB recipients starts on August 1 and ends on July 31 of the following year.
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