OHIP+ is coming on Jan. 1, 2018 – important information for patients and families

Starting Jan. 1, 2018, the Government of Ontario will cover costs of certain medications for people under the age of 25 years with a valid OHIP Card. This new program is called OHIP+.

According to the Government of Ontario, OHIP+ will completely cover the cost of more than 4,400 drug products that are currently available through the Ontario Drug Benefit program, including: antibiotics to treat infections; inhalers for asthma; various insulins, oral diabetic medications and diabetes test strips; epinephrine auto-injectors; medications to treat mental health conditions (e.g. antidepressants); attention deficit hyperactivity disorder (ADHD) drugs; and drugs to treat some childhood cancers and other rare conditions.

It is important to understand that OHIP+ will not automatically cover all medications.  

All children with a valid OHIP card, will automatically be enrolled in OHIP+ on Jan.1, 2018.  

If your child is already receiving prescription coverage under a government plan, such as Trillium, Ontario Works or Assistance for Children with Severe Disabilities (ACSD), OHIP+ will replace other government plans. If you have a private insurance plan, medications that are not covered by OHIP+ may or may not be covered by that plan. You may have to pay out-of-pocket for your or your child’s medication. Please let your or your child’s social worker, nurse, pharmacist or doctor know if this will be a burden for you or your family.

Here is what you need to do to minimize delays and disruptions to your or your child's prescription medication coverage.

Step One

Everyone should check online at ontario.ca/ohipplus to see if your or your child’s medication will be automatically covered by OHIP+.

If the medication is designated as “covered”, you do not need to proceed to Step Two. If any of your or your child’s medications are designated as “may be covered” or “not covered,” proceed to Step Two.

Step Two

If your or your child’s medication will not be automatically covered by OHIP+ and you have private insurance, contact your insurer to see if they will cover the medication.

If your or your child’s medications will not be covered by your private insurer, or you do not have a private insurance plan, proceed to Step Three.

Step Three

If your or your child’s medication will not be automatically covered by OHIP+, or by your private insurance, or if you do not have private insurance, please contact your child’s doctor, nurse, pharmacist, or social worker. They may be able to assist with identifying alternate sources of funding if medication costs will be a burden to you or your family.

If you have questions or concerns about your or your child’s medication coverage please speak to a member of your child’s health-care team at SickKids.

Learn more

SickKids is hosting information sessions about OHIP+ for patients and families on the dates listed below. Families are invited to attend for a brief overview of how OHIP+ is impacting their drug coverage and ask any questions they may have. All sessions take place in the Family Centre, located on the Main Floor, Black Wing, from noon to 1 p.m.

• Wednesday, Dec. 20
• Thursday, Dec. 28
• Thursday, Jan. 4
• Wednesday, Jan. 10

You can also reach out to the Government of Ontario at OHIPplus@ontario.ca.