Final details of the OHIP+ program are still coming in dribs and drabs.

One area where we may see issues is for those under 25 years old, currently on medication that is on the Ontario EAP formulary.  In the past, these medications were paid for by the benefit plan, but going forward the province will pay the cost once an application has been made to, and approved by, the provincial program.

Exceptional Access Program and OHIP+ – plan member action required

The province is recommending that for those individuals taking a drug on an ongoing basis, they should be encouraged to talk to their doctor to see if the drug is part of the government’s EAP.  If it is they should ask their doctor to submit an EAP request form now to avoid interruption of coverage on Jan 1. 

Due to the provinces change in process, failing to make this application could result in the benefit plan ceasing to pay for these often expensive drugs.

Communication about OHIP+ will continue in the coming months.

Bill 148 ($15 minimum wage and other labour/employment standards reforms) was referred again to the Ontario legislature’s Standing Committee on Finance and Economic Affairs. This committee will conduct public hearings next week in the Main Legislative Building at Queen’s Park in Toronto.

The tight deadlines for these hearings were finalized and made public only yesterday afternoon, but it’s not too late to make sure your voice is heard in person, or in writing.

IN PERSON:

To request to appear for a five-minute presentation before the committee on Thursday, November 2 (9:00-10:15 a.m. and 2:30-6:00 p.m.), contact the Standing Committee on Finance and Economic Affairs at commfinanceaffairs@ola.org or 416-325-3506 by no later than Monday, October 30 at 5 p.m.

(Please note: Just like the first round of hearings, if the number of requests to appear exceeds the number of spots available, a short list will be created by MPPs on the committee.)

IN WRITING:

Written submissions will be accepted until 5 p.m. on Friday, November 3.
Please email written submissions to comm-financeaffairs@ola.org.

This is the final opportunity to help influence the outcome of Bill 148. Your individual business story could make a difference!

While it might come as a surprise to some plan members, what may seem like a freebie or giveaway with the purchase of a medical device or service can actually count as benefits abuse. And in some case, offering incentives to customers will get a provider delisted by an insurance company.