Access to Medication

Ontario Drug Benefit Program

The Ontario Drug Benefit Program covers prescription medications for individuals on:

  • Ontario Works (OW)
  • Ontario Disability Support Program (ODSP)
  • Individuals age 65 and over
  • Individuals living in long term care facilities

To find out which medications are covered by ODB, search the Ontario Drug Benefit Formulary

Trillium Drug Program (TDP)

The Trillium Drug Program can help individuals with high medication costs in relation to their household income (4% or more). To be eligible, individuals must:

  • have OHIP coverage
  • not be covered by the Ontario Drug Benefit Program
  • have no private insurance, or private insurance that doesn’t cover 100% of drug costs
  • require only medications included in the Ontario Drug Benefit Formulary

The Trillium Drug Program application is available here.

Exceptional Access Program (EAP)

The Exceptional Access Program covers most of the costs of prescription drugs that are not included in the Ontario Drug Benefit Formulary or have been tried and do not work. Applicants must first be eligible for ODB program. Physicians submitting requests can access a standard form here.

Special Drugs Program (SDP)

The Special Drugs Program covers the full cost of certain medications for certain conditions including HIV infection and schizophrenia. To be eligible, individuals must:

  • have OHIP coverage
  • have their medications prescribed by a physician at a designated treatment facility

Non-Insured Health Benefits

Non-Insured Health Benefits is a federal program that provides additional health coverage for eligible registered First Nations and recognized Inuit for services not covered by provincial or private plans. NIHB provides coverage for prescription and over-the-counter medication that is prescribed by a physicians.

The NIHB benefit list is available here. A health provider guide to NIHB pharmacy benefits is available here.

Interim Federal Health Program

The Interim Federal Health (IFH) Program is designed to provide health coverage for refugee claimants and resettled refugees until they become eligible for OHIP. The IFH Program may provide medication coverage depending on refugee claim status and country of origin. IFH Program benefits are provided through Medavie Blue Cross.

A summary of coverage is available here.