Ontario Drug Benefit (ODB) Program : Application forms

Ready to apply to one of Ontario’s drug programs? You will find many of the forms and guidebooks you need right here.  You can open a form, fill it in on your screen and print it, or save a blank copy of the form to your computer.

Don't see a form you need? Talk to your doctor. For some programs, your doctor must complete the form for you..

TRILLIUM DRUG PROGRAM
3693-87

Application for Ontario Drug Benefits

Notice to Recipients of Ontario Drug Benefits

Mail completed Trillium Drug Program applications to:
Drug Benefit Programs – Trillium Drug Program
P.O. Box 337, Station D
Etobicoke ON M9A 4X3

Questions regarding the Trillium Drug Program application form should be directed to:

In Toronto, call 416-642-3038
Toll-free: 1-800-575-5386 or
E-mail : trillium@ontariodrugbenefit.ca

S46850E-87

Trillium Drug Program Guide (25 pages)

4423-87

Notification for Change of Information for Trillium Drug Program

SENIORS’ CO-PAYMENT PROGRAM
3233-87

Co-payment Application for Seniors

Notice to Recipients of Ontario Drug Benefits

Mail completed Co-payment applications to:
Drug Benefit Programs – Seniors’ Co-Payment Program
P.O. Box 384, Station D
Etobicoke ON M9A 4X3

Note: 
Increases to the Ontario Drug Benefit (ODB) Program's Seniors Co-Payment Program (SCP) income threshold were announced in the 2016 Budget and approved by the Ontario Government through recent amendments to Ontario Regulation 201/96 made under the Ontario Drug Benefit Act. The regulation was filed on April 14, 2016, and will come into force on August 1, 2016. The new changes  are as follows:

  • from less than $16,018 to less than or equal to $19,300 for single seniors, and
  • from less than $24,175 to less than or equal to $32,300 for senior couples.

The new thresholds are aligned with the Ontario Guaranteed Annual Income System and will be indexed to ensure they remain aligned in the future.

The new Co-payment Application for Seniors available online reflects the increased income thresholds that are in effect as of August 1, 2016 (for the program year 2016/17).  

Should you want to apply for this current 2015/16 program year (ending July 31, 2016), you can use the new Co-Payment Application available online.

The ODB program will accept completed new applications, and determine eligibility based on the income thresholds for each program year (i.e., program year 2015/16 that ends on July 31, 2016, and program year 2016/17 that begins on August 1, 2016).  

Questions regarding the co-payment application form should be directed to:

In Toronto, call 416-503-4586
Toll-free: 1-888-405-0405 or
E-mail : seniors@ontariodrugbenefit.ca

INHERITED METABOLIC DISEASES PROGRAM
4551-87

Application and Consent for the Inherited Metabolic Diseases (IMD) Program

For More Information

Call ServiceOntario, Infoline at 1-866-532-3161
In Toronto, 416-314-5518
TTY 1-800-387-5559
In Toronto, TTY 416-327-4282
Hours of operation : 8:30am - 5:00pm