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The Ontario Government is Making Changes to Ohip+ Under the Ontario Drug Benefit Program (ODB) Start

Heads up! The Ontario government has made changes to OHIP+ under the Ontario Drug Benefit Program (ODB) starting April 1, 2019

In February we shared with you that the Ontario government was making changes to OHIP+ under the Ontario Drug Benefit Program (ODB). This program was implemented on January 1, 2018 and provides drug coverage for individuals who are covered by OHIP and are 24 years old and under.

You can find a copy of what we sent you in the Advance Hub.

What’s changing

Effective April 1st OHIP+ will no longer cover individuals 24 years old and under with drug coverage through a private insurance plan, such as a company group benefits plan. These changes may affect some of your employees, their spouses and children.

You can see the official announcement from the Ontario government here as well as their Frequently Asked Questions for Patients.

What we’re doing to communicate this

For those impacted plan members whose email address we have on file, we’ll be reaching out to them via email. The email lets them know of the change and outlines additional steps they may need to take. We’ve attached it for your reference. You can share it with your employees.

Plan members will also see a banner on the home page of the group benefits plan member website letting them know of the changes.

What the Ministry of Health has done

The Ministry has sent a letter to individuals 24 years old and under who may be taking a drug paid under the Exception Access Program (EAP).

They’ve also sent letters to physicians who have patients 24 years old and under that have been approved for a drug through the EAP letting them know of the changes. And, asking them to help patients who may require approval from their insurer for the specific drug.

If you have any questions

We’ve put together an FAQ you can reference. It provides answers to questions that may arise. You can also reach out to Gene.

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