OHIP+: What does it mean for Canadians with type 1 diabetes?

OHIP+: What does it mean for Canadians with type 1 diabetes?

Great news for Ontario youth! Insulin, diabetes test strips and other prescriptions are now free for Ontarians who are 24 and under.

While we welcome this new measure, we hope it represents only the first step in achieving the goal of universal pharmacare in all provinces.

Many members of the T1D community have reached out to JDRF with questions about how exactly OHIP+ works. So here’s everything you need to know about OHIP+ and what it means for Canadians with a type 1 diabetes connection.

Who and what’s covered?

OHIP+ covers more than 4,400 drug products for anyone age 24 years or under automatically with an Ontario health card number. This includes insulin and diabetic testing strips for measuring blood sugar.

This table shows the type of treatment and number of test strips covered.

 
Diabetes Treatment Maximum number of strips (per year) covered
Patients Managing diabetes with insulin 3,000
Patients managing diabetes insulin medication with higher risk of causing hypoglycemia (low blood sugar) 400
Patients managing diabetes using medication with lower risk of causing hypoglycemia (low blood sugar) 200
Patients managing diabetes through diet/lifestyle therapy only (no insulin or medications used) 200

Source: Ontario Ministry of Health

If you want more than the maximum quantity, you have to pay for it yourself. Syringes and other diabetic supplies, such as lancets, glucometers, eyeglasses, dentures, hearing aids or compression stockings are not covered by OHIP+.

 

What if I’m a student out of province?

If you’re going to university or college in another province, you’re still covered as long as you have a valid prescription and get your medications from a pharmacy in Ontario. You may be able to get a larger “travel supply” before leaving Ontario.

 

What other choices do I have?

Other programs help people pay for diabetic supplies in Ontario, such as needles and syringes. Find out if you qualify for other coverage through:

 

I’m not from Ontario. How does it work in my province?

Each provincial and territorial government offers a drug benefit plan for eligible groups. Some are income-based universal programs. Most have specific programs for population groups that may require more enhanced coverage for high drug costs. For more info, click on your province:

 

Why 24 and under?

According to the Ontario Ministry of Health, young people aged 19-24 are less likely to have access to prescription drug coverage or the financial means to pay out-of-pocket due to higher unemployment and lower incomes.

Seniors receive coverage for the same prescriptions through the Ontario Drug Benefit.

For middle-aged adults, the Trillium Drug Program is available for people who spend 3 to 4% or more of their after-tax household income on drug costs. It covers the same prescriptions as OHIP+ and doesn't have an age restriction.

 

What’s the big deal?

OHIP+ is a great step in the right direction towards universal drug coverage. Ontario is the first province to provide prescription medication coverage at no cost for children and youth age 24 years and under, helping more people afford the medications that they need to stay healthy.

But let’s face it: Diabetes is a very costly disease. We hope that in time, insulin, diabetes supplies, devices and all needed drugs are 100% covered for all ages from coast to coast to coast.

As community member Daneille Owen-Bilida put it: “This is a start, but much more needs to be done.”

 

P.S: Help us put pressure on decision makers and advocate for better benefits for the T1D community by becoming a JDRF advocate. Join us and make a strong impact with your personal story.

 

 

Lets turn type one into type none