The Ontario Ministry of Health and Long-Term Care (the ‘ministry’) is proposing to update recipient cost-sharing arrangements for non-low income seniors as well as expand eligibility for the Seniors Co-Payment Program under the Ontario Drug Benefit (ODB) program.
Proposed amendments to Ontario Regulation 201/96 made under the Ontario Drug Benefit Act are required to support these proposed changes, which include:
- An increase to the income threshold for low-income seniors from <$16,018 to ≤$19,300 for single seniors and from <$24,175 to ≤$32,300 for senior couples;
- $70 increase to non-low income seniors’ annual deductible (from $100 to $170); and
- $1 increase to non-low income seniors’ co-payment per prescription (from $6.11 to $7.11).
Housekeeping changes to Ontario Regulation 201/96 are also included in this amendment and pertain to pharmacy claim submissions under the ODB program. The minor changes include:
- removing outdated dispensing physician offsets; and
- revising the two dispensing fee per month (30 days) policy to two dispensing fees per 28 days.
For a copy of the draft regulation that proposed to amend Ontario Regulation 201/96, please click on the following link.
Interested parties are invited to provide written comments on the proposed changes to the regulations as part of the review. The ministry will consider comments received on or before March 30, 2016 at 5:00 p.m. EST. Please submit your written comments to:
Executive Officer, Ontario Public Drug Programs
Ministry of Health and Long-Term Care
80 Grosvenor Street, 9th Floor
Hepburn Block, Queen’s Park
Note that the ministry may use and disclose received materials or comments to other interested parties during and after the comment period. Please contact the ministry’s Freedom of Information and Privacy Coordinator (416-327-7040) for more information.