As part of the 2017 Budget, Ontario is moving to make prescription medications free for children and youth.
Beginning January 1, 2018, all children and youth under 25 years old will be able to receive their prescription medications for free. Coverage will be automatic, with no upfront costs. All that is needed is their Ontario health card number and a prescription. Free prescription medication will be available to children regardless of their household income or whether they have access to private health insurance through their parents.
Currently, the province’s public drug plans cover 2.3 million seniors, and about 900,000 people on social assistance. The new program, “OHIP+”, would expand public coverage to another four million people.
Beyond the most common prescriptions, OHIP+ will give young people access to more than 4,400 drugs reimbursed under the Ontario Drug Benefit Program.
Included are medications listed under the Exceptional Access Program, at no cost. These include drugs to treat cancer and rare diseases. Prescription medications will be covered if they are listed on the Ontario Drug Benefit formulary or if they are funded through the Exceptional Access Program formulary and requested by a doctor.
The effect of OHIP+ on plan sponsors of Group Benefit Plans
How or when savings may be passed on to plan sponsors is yet to be determined. For many employers dependent children make up a small portion of total drug spend, however as drug costs for dependents under age 25 drop off the plan, plan sponsors should see some reductions in total drug spend.
As January 1, 2018 approaches, we expect further information from insurance carriers on this topic.
For additional details see:
Ontario News Release: Free Prescription Medications for Children and Youth Through OHIP+