Ontario’s Drug Plans: How much do I pay?

Under the Ontario Drug Benefit (ODB) Program, ODB eligible recipients may be asked to pay some portion of their eligible prescription drug product cost. Fees for people in the Trillium Drug Program (TDP) are calculated differently than the fees for other people in the ODB program.

For most of the ODB program (excluding the TDP)

The chart below sums up what you may be asked to pay. The amount you pay depends on your income.

If you are:Then you will pay:

Prior to August 1, 2016:

A single senior (aged 65 or older) with a yearly net income of $16,018 or more

A senior couple with a combined yearly net income of $24,175 or more

Effective August 1, 2016:

A single senior (aged 65 or older) with a yearly net income of more than $19,300

A senior couple with a combined yearly net income of more than $32,300

The first $100 of your prescription drug costs. This is called your "deductible."

AND

Up to $6.11 each time you fill a prescription covered under ODB. This is called your “co-payment”

If you are:Then you will pay:

Prior to August 1, 2016:

A single senior (aged 65 or older) with a yearly net income of less than $16,018, you qualify for the Seniors Co-Payment Program

A senior couple with a combined yearly net income of less than $24,175, you qualify for the Seniors Co-Payment Program

Effective August 1, 2016:

A single senior (aged 65 or older) with a yearly net income of less than or equal to $19,300,  you qualify for the Seniors Co-Payment Program

A senior couple with a combined yearly net income of less than or equal to $32,300, you qualify for the Seniors Co-Payment Program

Up to $2 each time you fill a prescription covered under ODB. This is called your “co-payment.”

Note:

You are encouraged to apply before the start of the program year that begins on August 1, 2016. 

Registered with:
  • The Ontario Works or the Ontario Disability Support Program (ODSP) or
  • Living in a Long-Term Care Home or Home for Special Care or
  • Receiving Home Care services.

Up to $2 each time you fill a prescription covered under ODB. This is called your “co-payment.”

If you are a senior you can apply to qualify for the lower ODB fees under the Seniors Co-Payment Program (SCP). If you don’t apply, you will have to pay the higher fees.

To get an application kit for the Seniors Co-Payment Program:

For the Trillium Drug Program (TDP)

Under the Trillium Drug Program, you will pay part of your prescriptions costs in two different ways each year:

  1. You will pay a set amount of your prescription drug costs each year. This amount is called your "deductible." The amount of your deductible is based on your household income. For most people, it equals about 4% of your household’s total net income. Net income is the amount of money you have after you pay your taxes.

    The deductible you have to pay is split into four equal amounts over the year starting on August 1st.  You pay your deductible by purchasing ODB approved drug products at your pharmacy. Once you have purchased enough of these products to equal the amount of your deductible, then the ODB program pays for most of the cost of your drugs.

  2. After you pay your deductible, your pharmacist may ask you to pay up to $2 for each prescription that the ODB program covers. This amount is called a “co-payment”.

To get an application kit for the Trillium Drug Program:

For More Information

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