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Prescription Drug

 Attention Out of Country and Out of Province Students!

Starting January 1, 2018, the Ontario government introduced a new program called OHIP+.  This program allows individual’s under 25 years old, covered under the Ontario Health Insurance Plan (OHIP) to receive free prescription medications for more than 4,400 drug products.  If you do not have OHIP, you must contact your benefit plan coordinator to indicate your home province or country.  If you visit a pharmacist before updating your home province/country your drug claims will be denied.     
   
Your drug plan covers 80% of the cost of most medications legally requiring a prescription to a maximum of $3,000 per benefit year.

The maximum amount payable to an eligible brand name drug will be limited to the lowest priced item in the appropriate generic category.

IMPORTANT! Advise your doctor and pharmacist that you are on the National Formulary.

The National Formulary is a specific list of drugs that are eligible for reimbursement under your drug benefit. Formularies are developed to ensure that prescription drugs are available on a cost-effective basis. It covers approximately 85% of the most frequently prescribed drugs. Formularies are reviewed regularly and as a result, updates are made on an ongoing basis.

Exception Process: In the event that the drugs covered by the Formulary are not effective in treating the condition, an exception process is in place. To be eligible for an exception, you must have tried one alternative drug listed on the Formulary. An exception drug request form is available below or from your Benefits Plan Office and must be completed by your physician. Completed forms may be returned to your Benefits Plan Office or can be faxed directly to the insurance company.

Request for Coverage of Exception Status Drug form

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