If yes, you are probably eligible to receive full public coverage of all prescribed medicines that are listed on the Ontario Drug Benefit Formulary/Comparative Drug Index after you pay a certain amount as part of patient cost-sharing. If you are a low-income senior, you are required to contribute $2 per prescription toward the cost of your pharmacist’s professional (dispensing) fee. Other seniors are required to pay a $100 annual deductible, plus up to $6.11 per prescription toward the cost of the pharmacist’s professional (dispensing) fee.
The formulary is available publicly, and it is possible to search it by looking up the name of the medication to see if it is covered. If your medicine is designated as a Limited Use Benefit, your dispensing pharmacist must provide a specific code when they submit your claim for coverage. If your medicine is listed under the Exceptional Access Program (EAP) benefit or if it is not listed and you need to apply for a compassionate review, click click here to learn more.
