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Ministry Status: Routine Monitoring and Engagement

OHIP+: Children and Youth Pharmacare

OHIP+ Stakeholder E–blast

Patients First

Update: OHIP+ Children and Youth Pharmacare Program

December 1, 2017


We are pleased to share this update on OHIP+: Children and Youth Pharmacare (OHIP+) with you.

You can count on regular emails like this as your source of ongoing information and updates on OHIP+.  We encourage you to share them with staff members, local stakeholders and other clinicians, and colleagues.

Allergen Program

The Allergen program provides first dollar coverage for eligible Ontario Drug Benefit (ODB) program recipients for certain drug products used to treat allergies and allergic reactions.

Allergen extract products reimbursed through the Allergen program may be provided by an authorized allergen extract supplier or through an accredited retail pharmacy.

Changes to the Allergen Program

Beginning December 1, 2017, all ODB-eligible individuals, including those who will be eligible through OHIP+ starting January 1, 2018  (individuals aged 24 years and under with OHIP coverage), will no longer require a Special Authorization (Allergen) (SAA) form for an epinephrine auto-injector (e.g. EpiPen® or EpiPen Jr®) to be reimbursed through the Allergen program. A valid prescription will still be required, and billing procedures will remain the same. This means that all ODB recipients will be covered for their epinephrine auto-injector at no cost if they have a valid prescription.

It is important to note that valid and complete SAA forms will still be required for all other products dispensed by pharmacies and reimbursed through the Allergen program. SAA forms will also be required in order for non-pharmacy allergen extract suppliers to submit claims for payment to the Allergen program.

Expanding access to needed prescription medications is in alignment with Ontario’s Patient’s First: Action Plan for Health Care, which is increasing access to care, reducing wait times and improving the patient experience.

More details on OHIP+ will continue to be provided. We welcome any comments, feedback or advice that you may have regarding OHIP+ and its implementation.

More Updates Coming

You can expect regular updates like this as we move forward.

Please Stay in Touch

Visit us online at www.ontario.ca/OHIPplus

OHIP+: Information for Professionals: http://www.health.gov.on.ca/en/pro/programs/drugs/ohipplus/

To automatically receive these updates, join our mailing list by emailing OHIPplus@ontario.ca

This document is available in alternate formats upon request.

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