Ontario Drug Benefits: ODB
The Ontario Drug Benefit (ODB) Program covers most of the cost of 4,400 prescription drug products, some nutrition products and some diabetic testing agents. To qualify, an Ontario doctor or other authorized prescriber must prescribe the drugs and you must buy them from either:
You are eligible for ODB program benefits if you live in Ontario, you have a valid Ontario health card and at least one of these statements applies to you:
- I am 65 years of age or older
- I live in a Long-Term Care Home or a Home for Special Care
- I am enrolled in the Home Care program
- I have high drugs costs relative to my income and am registered in the Trillium Drug Program
- I receive social assistance through Ontario Works or the Ontario Disability Support Program.
How much do I pay?
You pay a portion of prescription-drug costs based on your yearly income (after taxes) and marital status.
– Single senior with income above $19,300 / Senior couple with combined income above $32,300
- l The first $100 of total prescription costs each program year (August 1 to July 31 the following year)
- l After paying the deductible, up to $6.11 for each prescription, filled or refilled
– Single senior with income of $19,300 or less/ Senior couple with combined income of $32,300 or less
- You pay up to $2 for each prescription drug filled or refilled
The Trillium Drug Program: TDP
The TDP helps people who have high prescription drug costs relative to their household income.
- You live in Ontario and have a valid Ontario health card
- You are not covered under ODB
- You don’t have private health insurance or your private insurance does not cover 100% of your prescription drug costs.
What costs will I pay?
- The amount of your deductible is based on your household income
- The deductible you have to pay is split into four equal amounts over the year starting on August 1st
- You pay your deductible by purchasing ODB approved prescription drug products at your pharmacy
- After you pay your deductible, you pharmacist may ask you to pay up to $2 for each prescription that the ODB program cover
The Application Centre is open Mondays, Thursdays and Fridays, 8:30 a.m. to 4:30 p.m. and Tuesdays and Wednesdays from 8:30 a.m. to 6 p.m. It is closed on weekends and public holidays. The wait time is generally shorter between 8:30 – 10:30 a.m. and 2:30 – 4:30 or 6 p.m.
To apply for Ontario Works by telephone, find your postal code in the chart below and call the appropriate application phone line.
To be eligible for Ontario Works you must:
- live in Ontario
- need money right away to help pay for food and shelter, and
- be willing to take part in activities that will help you find a job
You can start the application process either online, by phone or in person. Once you’ve started the process, an Ontario Works caseworker will contact you to schedule an in-person meeting.
You will be asked to bring specific documents to the meeting, so that the caseworker can verify:
- your personal information
- information about members of your household
- your household’s financial needs
- your household’s income and assets
Ontario Disability Support Program: ODSP
ODSP income support helps people with disabilities who are in financial need pay for living expenses like food and housing. It also provides health benefits like drug and dental coverage.
- are 18 years of age or older
- live in Ontario
- are in financial need, and
- are a person with a disability as defined under the ODSP Act
Most applicants must go through a process to determine if they meet the program’s definition of a person with a disability. Under the ODSP Act, a “person with a disability” is a person with a substantial physical or mental impairment that is continuous or recurrent, and is expected to last a year or more.
In addition, the physical or mental impairment must directly result in a substantial restriction in the person’s ability to:
- take care of him or herself, or
- take part in community life.
The impairment(s), its duration, and the restriction(s) must also be verified by an approved health care professional.
You can call or visit your local ODSP office. You can also start your application online. If you apply online you will still need to come into your local office to continue the application with a caseworker. Applying online can help you find out if you are eligible for ODSP, as well as other social assistance programs.
Disability Determination Package
To determine whether you meet this definition after your meeting with a caseworker, your caseworker will give you a Disability Determination Package for you and your health care provider to complete. This package is used to collect information about your disability. The two main parts of the Disability Determination Package must be completed by an approved health care professional. These parts are:
- Health Status Report – collects information about your medical condition, its impairments, restrictions and expected duration, as well as your treatments
- Activities of Daily Living Index – collects information about the impact of your impairment on your ability to work, care for yourself and participate in the community