Ontario Drug Benefit
Who is covered?
Through the Ontario Drug Benefit (ODB) 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 (Ontario Works or Ontario Disability Support Program assistance), you are eligible for ODB coverage.
Prescription Drugs for age 65 and over
The Ontario Drug Benefit Plan (ODB) is the first payor for prescription drugs for those aged 65 and over. Should you enroll in an individual health care plan that insurance provider would be the second payor. What this means is much of your prescription drug costs should be submitted to and be reimbursed by ODB (speak to your pharmacist) and the residual balance, in the form of deductibles, dispensing fee caps and other such items can then be claimed under your new individual policy, or if none exists then paid by you.