In February we shared with you that the Ontario government was making changes to OHIP+ under the Ontario Drug Benefit Program (ODB). This program was implemented on January 1, 2018 and provides drug coverage for individuals who are covered by OHIP and are 24 years old and under.

What’s changing

Effective April 1st OHIP+ will no longer cover individuals 24 years old and under with drug coverage through a private insurance plan, such as a company group benefits plan. These changes may affect some of your employees, their spouses and children.

You can see the official announcement from the Ontario government here as well as their Frequently Asked Questions for Patients.

What we’re doing to communicate this

For those impacted plan members whose email address we have on file, we’ll be reaching out to them via email. The email lets them know of the change and outlines additional steps they may need to take. We’ve attached it for your reference. You can share it with your employees.

Plan members will also see a banner on the home page of the group benefits plan member website letting them know of the changes.

What the Ministry of Health has done

The Ministry has sent a letter to individuals 24 years old and under who may be taking a drug paid under the Exception Access Program (EAP).

They’ve also sent letters to physicians who have patients 24 years old and under that have been approved for a drug through the EAP letting them know of the changes. And, asking them to help patients who may require approval from their insurer for the specific drug.

If you have any questions

We’ve attached an FAQ you can reference. It provides answers to questions that may arise.

You can also contact your Manulife Representative.

Starting in March 2019, OHIP+ in Ontario will no longer provide drug coverage for individuals under the age of 25 if they have access to private insurance. This reverses the program, launched by the previous provincial government, which paid these claims through the public plan.

We’ll make the necessary changes to ensure that those plan members and their dependents affected by this change will be covered for drugs that today are being paid for by the province and are eligible expenses with their Manulife benefits plan.

This may have an effect on your premiums/deposits. If so, you can expect to see these at the next renewal, beginning with April 2019 renewals, no premium/deposit changes will be rolled out mid-contract.

We’re actively working with the CLHIA and the Ministry of Health to look for solutions to ensure a smooth transition and minimize the impact.

We’ll continue to share details as they become available. We will also share information with plan members on the plan member website. Once we receive confirmation of the exact effective date in March, we’ll reach out to you again with a communication you can share with your affected plan members on next steps.

For now, if you have any questions, please contact your Manulife Representative.