Ontario – Universal drug coverage for Youth

The government of Ontario released its 2017 budget on Thursday April 27, 2017.  Contained within the 2017 budget was a surprise policy announcement: the creation of a new drug program called OHIP+: Children & Youth Pharmacare. This will benefit all Ontario Resident’s age 24 and under.

This new drug benefit program, effective January 1, 2018, will fully cover the cost of eligible prescription drugs with no deductible or co-pay and include those drugs currently listed on the Ontario Drug Benefit (ODB) program. Today over 4,400 medications are included on the ODB formulary. However, there are medications that are not covered by the ODB, which will continue to be covered under your benefits program.[1]

Coverage will be available regardless of family earning levels or if the resident already has private insurance.

Given the limited details currently available, we are still evaluating the government’s program and impact on our Ontario based clients. Some preliminary industry analysts have estimated a 5% to 7% reduction in overall drug claims.

Most insurers are not making any changes to medical/drug premium rates until further details are released. The Leslie Group will be factoring in the Ontario Drug Benefit program as part of your upcoming annual renewal to ensure your plan costs remain fair and competitive. Further details are available on the Government of Ontario website.

We will advise you on the details of the new program as well as the Insurance Industry’s response, as soon as they are released.

The Leslie Group is a full services consulting firm committed to staying on top of relevant issues pertaining to benefit programs. Should you have questions, please contact your Employee Benefits Consultant at The Leslie Group Limited.

Source: https://news.ontario.ca/mof/en/2017/04/ontario-to-provide-free-prescription-drugs-for-children-and-youth.html

 

 

[1] Programs with restricted formularies will have any top-up coverage applied as per their formulary.

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