This means that when someone other than you for example, private insurance, a drug company or a drug discount card pays for all or a part of the drug cost, this portion will not count as a deductible payment. Rather than ask you to pay the whole annual deductible at the start of the year, we divide it into four equal amounts quarterly deductible and we divide the program year into four equal periods quarters. As each new quarter begins, you will pay for your prescription drugs out-of-pocket until you have paid off your deductible for that quarter.
After that, your Trillium Drug Program coverage will begin and will continue until the end of that quarter. If you do not buy enough prescription drugs to meet your deductible before a quarter is over, we will carry your unpaid deductible over to the next quarter.
Examples of documents to include are:. When the ministry receives your documents, we will re-asses your household deductible and send you a letter to tell you the new amount. If you are on the Trillium Drug Program, you can request a three-month supply of some drugs used to treat certain chronic conditions, such as:. Talk to your pharmacist to find out which drugs qualify and learn how to request a three-month supply.
If you're planning to travel outside the province, you may be able to get a larger supply, but you can only do this once during the Trillium Drug Program year, which is between August 1 and July 31 the following year. Keep in mind that prescriptions filled outside Ontario are not covered by the Trillium Drug Program. To have a better experience, you need to: Go to your browser's settings Enable JavaScript.
Home Health and wellness Drug coverage. Get help with high prescription drug costs If you have high prescription-drug costs — compared to your household income — you might qualify for the Trillium Drug Program.
On this page Skip this page navigation. Trillium Drug Program TDP application To submit a Trillium Drug Program application or supporting documentation, you can either : fax the documents to e-mail the documents to trillium ontariodrugbenefit. Seniors Co-Payment Program SCP application To submit a Seniors Co-Payment Program application or supporting documentation, you can either : fax the documents to e-mail the documents to trillium ontariodrugbenefit.
For seniors people age 65 and older , we will send you a letter about three months before your 65 th birthday to let you know you will automatically join the Ontario Drug Benefit program on the first day of the month after you turn 65 years old. The Ontario Drug Benefit program is for Ontario residents only and prescriptions must be filled in an Ontario pharmacy to be covered.
Your pharmacist will need your health card to confirm your eligibility for the Ontario Drug Benefit program. The Ontario Drug Benefit program covers most of the cost of approximately 5, prescription drug products. Search for covered drugs. Antihistamines and mixtures used in testing for allergies are not covered by the ODB program.
Some products used to monitor and test for diabetes are covered by the Ontario Drug Benefit program. This includes diabetic testing strips for measuring blood glucose sugar — a common product prescribed by doctors or nurse practitioners to patients living with diabetes.
Syringes and other diabetic supplies, such as lancets, glucometers, eyeglasses, dentures, hearing aids or compression stockings are not covered by the ODB program. The Ontario Drug Benefit program covers the cost for a maximum number of diabetic testing strips based on your current treatment method and clinical guidelines set by the Canadian Diabetes Association. Other programs help people pay for diabetic supplies, such as needles and syringes.
Find out if you qualify for other coverage through:. Some drugs can be purchased without a prescription also called over-the-counter drugs , if you pay for them yourself. The Ontario Drug Benefit Program may cover the cost of these drugs but only if your physician or nurse practitioner gives you a prescription for them and if the drugs are either:.
If you think that the cost of an over-the-counter drug should be covered, check with your healthcare provider before buying the drug to avoid out-of-pocket costs. The Ontario Drug Benefit program covers the cost of nutrition products up to a maximum dollar amount. The product must be your sole source of nutrition and be prescribed by your doctor or nurse practitioner. Besides writing you a prescription, your doctor or nurse practitioner must fill out a Nutrition Products form for you to receive coverage, stating that the product is the sole source of your nutrition.
It also does not cover a nutritional product used for:. If you do not have a doctor who is registered on this list, you will need to be referred to one. The Ontario Drug Benefit program covers some drugs used in palliative care for example, higher strength narcotic drugs for pain.
The drugs must be:. Note that you will also need to consult with a doctor or nurse practitioner who is registered on the Palliative Care Facilitated Access List if you are requesting a high strength opioid through the Exceptional Access Program, including the telephone request service.
To qualify for the Exceptional Access Program, including applications through the Compassionate Review Policy, you must:. Your doctor or nurse practitioner fills out and submits the application for you. Only a doctor or nurse practitioner can apply for coverage through the Exceptional Access Program or Compassionate Review Policy. Your doctor or nurse practitioner must submit the completed form by fax, using one of the numbers below:.
Pharmacists who specialize in the Exceptional Access Program carefully consider each application. In some cases applications are sent out for medical expert review. These pharmacists and experts base their review on standards set by a group of medical experts and patients called the Committee to Evaluate Drugs CED.
The executive officer makes the final decision. Applications to the Exceptional Access Program and Compassionate Review Policy are reviewed as quickly as possible and a decision on your application will be sent directly to your doctor or nurse practitioner by fax in 3 days to 6 weeks starting on the business day your complete application is received.
If possible, wait for approval before getting your prescription filled. We can only help you pay for a drug once your application has been approved. Otherwise you must pay for the full cost of the drug yourself. Weekly turnaround times progress reports.
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