Prescription medications can be expensive. And while more than 97 per cent of Canadians have at least some form of drug coverage, there are at least one million who don’t have access to essential medicines.1 For many, this can mean choosing between paying for prescription medication or meeting basic needs. Fortunately, some programs can help.
Earlier this year, GreenShield launched a first-of-its-kind program to provide essential medications to low-income Canadians without public or private drug coverage.
The Essential Medicines program is a solution designed to fill the gap for many Ontarians without coverage. In addition to GreenShield’s program, there are public drug programs available in Ontario to help cover the costs of vital medications. In this post, we break down what public drug programs are available to help pay for medications in Ontario, and how to find the right support for you or a loved one.
The role of a drug program
Essential medicines are essential for a reason. They are integral to a person’s quality of life and support positive health outcomes. That’s why access to essential medicines is a fundamental human right, according to the World Health Organization.
Drug programs can help ease the financial burden of certain prescription medications for those who are eligible, so cost isn’t a barrier to maintaining health.
There are several different programs available that you may be eligible for depending on a number of other criteria including age, employment status, the medical conditions you live with, and the type of medications you take.
Understanding Ontario's drug programs
Navigating resources takes time, so we’ve compiled a list of public programs providing access to prescription medication below. Here, you’ll find details about each program and some of their eligibility requirements, as well as a link to learn more and apply.
The Trillium Drug Program provides drug coverage assistance for Ontario residents of any age whose drug costs are high compared to their household income, or whose insurance plan does not pay 100 per cent of their prescription medications.
The Ontario Works program provides monthly financial assistance to individuals in Ontario who are 16 years or older while they are looking for employment. Amounts are determined by an individual’s circumstances. If you are receiving Ontario Works financial assistance, you and your family can get coverage for prescription drugs listed in the Ontario Drug Benefit Formulary.
The Ontario Disability Support Program provides Ontario residents 18 years or older with monthly financial support for drug costs. An individual must meet the definition of disability under the Ontario Disability Support Program Act or be a member of a prescribed class to be eligible. While on ODSP, you and your family can receive coverage for prescription drugs listed in the Ontario Drug Benefit Formulary.
The Special Drugs Program covers the costs of a defined list of drugs used to treat patients with a specific disease or condition. To be eligible, an individual must be an Ontario resident, meet the established criteria of the program, and be under the care of an approved physician or designated care centre.
The Inherited Metabolic Disease Program is offered to residents of Ontario who have been diagnosed with an inherited metabolic disorder and who are under the care of a physician from a designated treatment centre. The program covers the full cost of certain outpatient drugs, supplements, and specialty foods used to treat specific inherited metabolic disorders.
ODB provides coverage for prescription drugs to individuals in Ontario without private drug coverage once they turn 65 and helps pay most of the cost of more than 5,000 prescription drug products. Three months before an individual turns 65 years old, the province sends a letter informing them of their automatic enrolment. Individuals may qualify earlier based on other criteria, e.g., if you are 24 years old or younger (OHIP+) and not covered by a private insurance plan.
OHIP+ provides more than 5,000 drug products at no cost for children and youth in Ontario between birth and 24 years of age who don’t have private drug coverage. There is no enrolment required — all that’s needed is a health card number and an eligible prescription.
Are you eligible for free prescription drug coverage?
Whether you’re a single parent juggling multiple jobs, a retiree working part-time but living on a fixed income without private health coverage, or a 25-year-old whose medications no longer covered by the provincial health plan, it’s important to seek out assistance and support if you need it.
You can also learn more about publicly funded programs that assist with drug costs in Ontario by:
- Reaching out to your local community agency;
- Calling or text 211, a helpline that connects people to the support they need;
- Contacting Service Canada by phone at 1.866.532.3161 (toll-free) or 1.800.387.5559, by email at firstname.lastname@example.org, or book an appointment here.
1 The Conference Board of Canada, Understanding the Gap 2.0