Benefits begin the first day of the following month that you turn 65 – i.e. turn 65 Aug 22 benefits will begin September 1. The benefit year for all ODB recipients starts on August 1 and ends on July 31 of the following year.

ODB eligible people may be asked to pay some portion of their prescription drug product costs as follows:

Single seniors (people aged 65 or older) who have an annual income of $19,300 or more and seniors in couples (where both spouses are over 65 or if only one spouse is over 65) with a combined annual income of $32,300 or more, pay an annual $100 deductible per senior before they are eligible for drug coverage. After these seniors pay the deductible, they then pay up to $6.11 toward the dispensing fee each time they fill a prescription for a covered drug product in Ontario in the benefit year.

An important note — seniors who begin receiving Ontario drug benefits at age 65 between August 1 to July 31 in a year, may not have to pay the full $100 deductible during their first year in the program. It depends on the birth date month. This policy applies only for the first year when a senior becomes eligible for ODB. For every year after seniors will pay a full $100 deductible each year.

Single seniors who have an annual income below $19,300 and seniors in couples whose combined annual income is less than $32,300 and all other ODB eligible people may be asked to pay up to $2 each time they fill a prescription.

For more information you may wish to view the following link:
https://www.ontario.ca/page/get-coverage-prescription-drugs

“Co-Payment Application for Seniors”
http://www.forms.ssb.gov.on.ca/mbs/ssb/forms/ssbforms.nsf/FormDetail?openform&ENV=WWE&NO=014-3233-87

You may also wish to contact the Ontario Drug Benefit (ODB) program directly if you need more information.

Drug Programs
3rd Floor, 5700 Yonge Street
Toronto ON  M2M 4K5
Telephone: 416-327-8109
Toll free: 1-866-811-9893
Fax: 416-327-8123

You may wish to view the following link regarding OHIP coverage:
http://www.health.gov.on.ca/en/public/publications/ohip/services.aspx

You may wish to view the following fact sheets for information regarding physiotherapy and eye care services for seniors:
http://www.health.gov.on.ca/en/public/programs/physio/default.aspx
http://www.health.gov.on.ca/english/public/pub/ohip/eyecare.html

In addition, seniors who need insulin every day and lives at home can apply for $170 annually to help pay for syringes and needles through the ministry’s Assistive Devices Program.

The ADP is a MOHLTC program with a mandate to financially assist Ontario residents with long term physical disabilities so that they may obtain basic, competitively priced, personalized assistive devices appropriate for their individual needs and independent living.

Assistive Devices Program
5700 Yonge Street, 7th Floor
Toronto ON  M2M 4K5
Telephone: 416-327-8804
Toll-free: 1-800-268-6021
TTY: 416-327-4282
TTY toll-free: 1-800-387-5559
Fax: 416-327-8192

Email: adp@ontario.ca

Website: https://www.ontario.ca/page/assistive-devices-program

Orthodontic treatment, including braces, is not an insured service under OHIP. In addition, dental implants, mouth guards, and the replacement of teeth through crowns, bridges, and dentures, are also uninsured services. Any dental services that are performed in a non-hospital setting, such as in a dentist’s private office, are not insured, including consultations and post-operative visits. OHIP insures only very limited dental services and only when there is a medical necessity for those services to be performed in a hospital.

OHIP is not intended to be a comprehensive dental care plan or a replacement for private dental coverage and, unfortunately, there is no provision under the HIA that enables the ministry to exercise discretion in extending coverage to services that are not prescribed by the legislation.

You may also wish to contact your local public health unit, as they may provide dental treatment to low income families (seniors included).

Public Health Unit Locations:
http://www.health.gov.on.ca/english/public/contact/phu/phuloc_mn.html

You may also wish to use the following link to view “A Guide to Programs and Services for Seniors in Ontario” on the Ontario Seniors’Secretariat’s website:

Ontario Seniors’Secretariat
http://www.seniors.gov.on.ca/

Regards,
Dennis Ewaniuk
TPPA

Terry Hill, Communications Director, PPAO

www.ppao.ca

ppao@ppao.ca