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News and Updates
Changes to OHIP+ effective April 1, 2019
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Starting April 1, OHIP+ will no longer provide prescription drug coverage for individuals 24 years old and younger if they have drug coverage through a private insurance plan.
What you need to do
If you, your spouse or your children are 24 years old or younger, let your pharmacist know you have coverage under a group benefits plan. To make things easier, have your benefits card handy next time you fill a prescription. You can print a copy of your benefits card online when you sign in to the OTIP plan member secure site.
If you or an eligible member of your family is taking a high cost drug
Some high cost prescription drugs require prior authorization under your group benefits plan.
To see if a drug requires prior authorization:
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Log in at the top right hand corner of the website and click on My Claims
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Under My benefits select My drug plan and search for the prescribed drug
If the drug being prescribed is eligible for coverage, requires prior authorization and is not being administered in a hospital, here’s what you need to do:
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Scenario |
What you need to do |
How to submit |
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If your pre-authorized drug was approved and paid for by OHIP+ |
Simply send OTIP the OHIP+ approval letter or a prescription receipt and phone number.
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Please include:
Submit by mail or fax to:
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If your doctor has recently prescribed a high cost drug and you haven’t started taking it |
You’ll need to fill out and submit a Drug Prior Authorization form found at forms page. |
Submit by mail or fax to:
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Learn more from the Government of Ontario’s OHIP+ Redesign Frequently Asked Questions for Patients.
Questions? Please call OTIP Benefits Services at 1-866-783-6847.