Announcement

Collapse
No announcement yet.

meds in Ontario

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

    meds in Ontario

    can anyone tell me how the coverage system works in Ontario for psychiatric drugs? (basically, do you have to pay and if how much...) I found the page mentionning The Ontario Drug Benefit Program and the Trillium Drug Program. Is this the one used?

    thanks

    #2
    Hello Lyxia. Yes that is what you use. Ontario drug benefit plan and Trillium are essetentially the same thing but applied to different people. That is, whatever meds are coverecd under one plan are also covered under the other.

    The only difference is how much it will cost you. If you are a senior or on some sort of public assistance then generally the Ontario drug benefit plan applies.(or have extremely low income) Generally these are free or very low cost.

    Anyone who has an income qualifies for the Trillium plan. The trillium plan roughly works like this. You take your last years income, say $20,000 and mulitply it by 4% = $800. You take the 800 and divide it by 4 =$200. Thus every 3mths you will pay the first $200 for you medications and then $2 per prescription after that. At the start of the next 3 mth period you pay the first $200 again etc etc.

    The trillium plan is not cheap, someone making $12 hr would end up paying a minimum of almost $1000 per year for their meds. So it depends on how expensive your meds are as to whether or not it is worth using the plan. Take Care. paul m
    "Alone we can do so little;
    Together we can do so much"
    Helen Keller

    Comment


      #3
      When I was on the Trillium plan a few years ago it didn't work like that--but then again, they were super fussy about which meds they would cover and they wouldn't cover most of the ones that my pdoc prescribed, and the ones they did cover were the cheap ones anyways.

      My recommendation: apply for health insurance BEFORE you get some sort of diagnosis that makes you a liability to insurance companies so that they won't take you on.

      astronaut

      Comment


        #4
        thank you Paul for the very clear answer. how can one survive trying to work and be stuck in between the low-wage and the wage that allows you not having to think of not buying your meds.... 1000 dollars is a lot. and it does not necessarly cover all....

        Comment


          #5
          Hello Lyxia. One thing that I didn't mention is that if a person is really low income and because of this income they do not quailify for OW(welfare) benefits then they may still quailify for the medical end of OW(what a dumb name OW=Ontario Works)

          That is, you may earn too much to get OW, but still quailify to get free meds, however the threshold is still very low. I'm not sure how much exactly, but low as the max that you can get on OW is about $600 per month. Unfortunately they have no central # to call, you have to call the local OW office for info. Take Care. paul m
          "Alone we can do so little;
          Together we can do so much"
          Helen Keller

          Comment


            #6
            i will call. but of hand you wouldnt know what the threshold is like. i mean 12 dollars an hour is not a lot to start with... ive been searching the web but i cant seem to find anything.

            Comment


              #7
              Hello Lyxia. I don't know the exact threshold. The following is just a guess on my part and you would really have to talk to someone there.

              The maximum that OW will pay is $599 per mth. If collecting OW and working they take 50 cents off for every dollar earned. So the most a person can earn in a mth and still be techniqually eligble for OW is 1196 per mth. 1196 divded by 2=598 and thus a person would quailify for an OW payment of $1.

              A person must be eligble for OW benefits in order not to have a deductable. There are certain hardship exceptions, but once again I have no idea what this province calls a hardship.

              In my first answer I was a bit high when I said it would be $1000 per yr for someone making $12 hr, it would be about $700 per yr, but that is still expensive enough. The actual chart and correct calculation can be found at: http://www.forms.ssb.gov.on.ca/mbs/ssb/forms/ssbforms.nsf/GetFileAttach/014-S46850E-87~17/$File/TXT_trilliumBookE.htm#s4 Take Care. paul m
              "Alone we can do so little;
              Together we can do so much"
              Helen Keller

              Comment


                #8
                So if you are on OW are all your psychiatric meds covered?
                thanks for the answers btw

                Comment


                  #9
                  Hello Lyxia. If you are on OW or ODSP (Ontario Disbility Support Payments) then all of your cost of eligible psych meds are covered. An eligible pysch med is generally an older psych med. For example if you take Pristiq it probably isn't covered as it is a fairly new med. If you want to know which ones are covered, go to: https://www.healthinfo.moh.gov.on.ca...lary/index.jsp It can be a little tricky to use. If you enter the brand name and it is now a generic drug, you will come up with a no result.

                  In regards to OW and ODSP, everybody has to apply to OW first. If you survive the 6-10 mth long processing time and hoop jumping through contest they will pay the difference in back pay between the OW and ODSP rates. ODSP pay a max of around 1,100 and OW $600. The drug benefits are the same. With ODSP you can work a little, but I'm don't know how much. Take Care. paul m
                  "Alone we can do so little;
                  Together we can do so much"
                  Helen Keller

                  Comment

                  Working...
                  X