Did you know that not all prescription drugs are covered by the Ontario Drug Benefit?

Many seniors assume that if a drug is prescribed by their doctor, the cost is automatically covered by the Ontario Drug Benefit. We often have to explain that the Ontario Drug Benefit covers a selected list of drugs. If the drug prescribed by their doctor is not on that list, the patient will have to pay out of pocket for the drug.

For seniors with their own additional private insurance (i.e. from current or previous employment), the cost may be covered by the private insurance. However for most seniors, they are often surprised when the drug cost is not covered by the government. Furthermore, the cost of some prescription drugs can be quite expensive.

How do we know which drug is covered by the Ontario Drug Benefit? 

The simplest way is to give your Health card and your prescription to your pharmacist to try billing it online. The pharmacist can tell you if the cost of the prescription is covered or if their are any specific criteria required for the drug cost to be covered. In the latter case, the pharmacist can help by asking the doctor to provide a "limited use code" that applies to your condition. 

For those of us who likes to search for information online, there is a website for which you can enter in a drug name and search through the formulary drug list to see if the drug is covered by the Ontario Drug Benefit. The website address is:

https://www.healthinfo.moh.gov.on.ca/formulary/index.jsp

To search the database, you will need to know the spelling of the generic/brand drug name or the drug identification number (DIN).  

What are some examples of drugs that are not covered by the Ontario Drug Benefit? 

The list of drugs covered by the Ontario Drug Benefit updates several times a year. Some drugs will get added to the list and some drugs will get removed off the list. Recent examples of drugs that were not covered includes some pre and post cataract surgery eye drops, cough syrup with decongestant, anti vertigo drug, shingles vaccines, etc.  

To help seniors who paid out of pocket for prescription drugs that are not covered by the Ontario Drug Benefit, Custom Care Pharmacy established a unique fund:

Custom Care Pharmacy's FUND FOR SENIOR

Call us at 905-305-0111 for details about eligibility.

This fund is 100% paid for by Custom Care Pharmacy.  It is our way to thank seniors for giving us their trust and support. We value your continuous support.

Thank you.