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Ontario Drug Benefit (ODB) Program
Ontario Drug Benefit (ODB) Program
The Ontario Drug Benefit (ODB) program helps eligible Ontario residents pay for prescription medications and some health products.
Full information is updated on government website: https://www.ontario.ca/page/get-coverage-prescription-drugs
Check full medication coverage here: https://www.ontario.ca/check-medication-coverage/
Forms to sign up here: https://forms.ontariodrugbenefit.ca/portal/EFormUpdate.aspx?usid=a2254b47-44d9-4cda-87fc-1a7bf516f9c1&eFormId=600a8fe9-059f-4688-a358-3e9af217b5bc&DomainID=e98ae7fc-3a6c-42aa-8845-b6b165a4dd9c
Who Qualifies
Who Qualifies
You may qualify if you:
Are age 65 or older
Are 24 or younger without private insurance (OHIP+)
Receive Ontario Works (OW) or Ontario Disability Support Program (ODSP)
Live in a long-term care or community home
Receive professional home/community care services
Are enrolled in the Trillium Drug Program
What’s Covered
What’s Covered
ODB covers:
Over 5,900 prescription medications
Some diabetes testing supplies
Allergy shots and epinephrine auto-injectors
Certain over-the-counter medications (with prescription)
Some nutrition products
Some palliative care medications
Smoking cessation medications
Some medications may require approval through the Exceptional Access Program (EAP).
What’s Not Covered
What’s Not Covered
ODB does not cover:
Drugs purchased outside Ontario
Medications not listed in the ODB Formulary or approved through EAP
Generic vs. Brand Name Drugs
Generic vs. Brand Name Drugs
ODB usually covers the lower-cost generic version of medications. Brand-name drugs may be covered in special situations, such as adverse reactions to generics.
Limited Use & Biosimilars
Limited Use & Biosimilars
Some drugs are only covered under certain medical conditions (“Limited Use”).
For biologic medications, patients may need to switch to approved biosimilar versions to maintain coverage unless medically exempt.
Costs
Costs
Costs depend on eligibility:
Seniors may pay a deductible and small co-pay
Many other eligible groups pay up to $2 per prescription
Some groups pay no deductible
Low-income seniors may qualify for reduced co-payments through the Seniors Co-Payment Program.
Refunds & Reimbursements
Refunds & Reimbursements
If you paid for a covered medication, you may request reimbursement by submitting receipts to the Ontario Drug Benefit Program.
Travel & 3-Month Supplies
Travel & 3-Month Supplies
Eligible patients may:
Request up to a 3-month supply for chronic medications
Obtain larger travel supplies when leaving Ontario for extended periods
Prescriptions filled outside Ontario are generally not covered.
The Trillium Drug Program
If you have high prescription-drug costs — compared to your household income — you might qualify for the Trillium Drug Program
Who should apply
Who should apply
You should apply if you:
live in Ontario
have a valid Ontario health card number
do not already qualify for the Ontario Drug Benefit program (for example, you are not enrolled in a program such as Ontario Works)
do not have an insurance plan that pays for 100% of your drugs
spend about 4% or more of your after-tax household income on prescription-drug costs
What is covered
What is covered
The Trillium Drug Program covers the cost of more than 5,900 medications that are currently available through the Ontario Drug Benefit program, and almost 1,500 additional drug products that meet specific criteria through the Exceptional Access Program (EAP).
How to apply
How to apply
The Trillium Drug Program year is from August 1 to July 31. Make sure you apply by September 30 to be reimbursed for any eligible drug you received in the previous program year (August 1–July 31).
To avoid unnecessary delays and ensure timely processing, complete the Trillium Drug Program Application available on the Ontario Drug Benefit Program Online Applications and Forms website. The online form will guide you through the application process to ensure all the information required for enrolment is provided before submission.
The senior’s Ontario Drug Benefit deductible and prescription co-payment
The senior’s Ontario Drug Benefit deductible and prescription co-payment
If you are a low-income senior with income below certain thresholds, you can have your Ontario Drug Benefit annual deductible waived and co-payment fees reduced to up to $2 by applying for the Seniors Co-Payment Program (SCP).
Who should apply
Who should apply
To apply
To apply
You should apply for the SCP if you have an Ontario health card number, you are aged 65 years or older, and you qualify under certain income eligibility thresholds.
Income eligibility thresholds
Income eligibility thresholds
Individual annual net income threshold
Individual annual net income threshold
Program year August 1, 2026 to July 31, 2027: $25,480
This applies to a senior who:
does not have a spouse
has a married spouse with whom they no longer live in a conjugal relationship
has a spouse living in a long-term care home or community home for opportunity
See previous program year income thresholds.
Combined annual net income requirement
Combined annual net income requirement
Program year August 1, 2026 to July 31, 2027: $42,290
This applies to a senior who has a spouse, other than a spouse described.
See previous program year income thresholds.
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