Big changes are coming to OHIP+ drug coverage next month. The Ontario government will make OHIP+ drug coverage available to only Ontarians under the age of 25 if they do not possess drug coverage through a private drug benefit plan. Ontarians 25 and under without private drug benefit coverage will continue to benefit from OHIP+. This change was announced last year and will take effect next month, March 2019.
OHIP+ coverage currently enables access to approximately 4,400 medications, including asthma inhalers, antibiotics, insulin, diabetes test strips, and birth control, as well as drugs to treat depression, anxiety, epilepsy, and attention deficit hyperactivity disorder. All of these medications are included in the Ontario Drug Benefit Formulary
Effective January 1st of last year, the OHIP+ youth pharmacare initiative was implemented by the previous Ontario government, spearheaded by Kathleen Wynne. But in June of 2018, the new Ontario government, led by Premier Doug Ford, announced its plans to amend the program.
"Those who are covered by private plans would bill those plans first, with the government covering all remaining eligible costs of prescriptions," Health Minister Christine Elliott explained, specifying that because private insurance plans are capable of covering thousands of more drugs than those offered under OHIP+, youth under 25 will thus be able to access more medications.
Certain provincial patient advocacy groups had called onto the Ontario government to "revamp" the OHIP+ pharmacare plan, causing families with private drug coverage to use their own plans first. According to a spokesperson, this would free up funds to finance expensive drugs for kids and young adults who are suffering from rare diseases.
These "cost-friendly" modifications to Ontario's current pharmacare program are a crucial component of the PC government's promise to save billions of dollars every year by identifying "efficiencies" in government spending, according to Elliott.
OHIP+ coverage will now focus on Ontario residents "who do not have existing prescription drug benefits" while also "saving the taxpayers money," she explained, "Premier Ford promised the people he would find efficiencies without compromising service or jobs, and we are delivering."