Taxpayer-funded prescriptions for people under the age of 24 with private insurance are coming to an end.
Youth in Ontario without coverage will still be eligible for about 4,400 medications as part of the pharmacare plan introduced by the Liberal government.
The change from the province will be implemented on April 1. According to a post on the government’s website, this will be to focus benefits on youth without the private plans.
“If you don’t have insurance, you will be covered by OHIP+ under the new system,” said pharmacist Nikola Jovovic of Westmount Place Pharmacy. “If you’re under private insurance, then you will be in the same situation as before the program was implemented.”
This way, private insurance plans become the “first payer” for prescription meds.
“Patients who have coverage through their school, parents, or employers will no longer be eligible for government funding,” said Jovovic.
Students have the option of opting in or out of private coverage through post-secondary schools.
At the University of Waterloo, eligible prescription drug costs are covered at 80 per cent and up to $12,500 per policy year.
Students are responsible for 20 per cent of the ingredient cost or $15, whichever is less.
The health plan covers prescription medications listed in the ODB Formulary, which includes most oral contraceptives, diabetic supplies, and allergy serums.
“Most private plans will either have an annual limit and a co-payment, so for some they may be getting and increase in costs,” said Jovovic. “Some patients who are on two private plans may still be getting the full cost covered even if it’s not going through the government.”
Some aspects that the government covers, like counseling from pharmacists to quit smoking, will sometimes not be covered by private plans.
People who have significant out-of-pocket costs, even if they have private insurance coverage, could apply for additional financial support through the Trillium Drug Program.
