Have kids under 25 taking higher cost speciality drugs?

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.