The Ontario Health Insurance Plan, or OHIP, only pays for doctors and other health care professionals to provide certain medical services, according to the Ontario Ministry of Health and Long-Term Care. However, once Ontario residents who qualify for OHIP are 65 or older, they immediately qualify for the Ontario Drug Benefit Program. This program pays the majority of the cost of 3,800 different prescription drugs, some diabetic testing supplies and certain nutritional products.
Ontario seniors who want to know what drugs the Ontario Drug Benefit Program covers can use the Ontario Drug Benefit Program formulary search engine to look for specific medications, explains its website. The formulary search engine allows people to search by coverage status, therapeutic classification, manufacturer or keyword.
In addition to the 3,800 medications covered by the formulary, some patients qualify for additional specialized drugs, notes the Immunodeficiency Clinic of Toronto General Hospital. The Ontario Drug Benefit Program files these drugs under the facilitated access list. To receive coverage, a doctor who is specially authorized by the program must prescribe these drugs to the patient. Medications that treat unique conditions, such as HIV, are in this category.
Prescription drugs that do not fall under the facilitated access list or the formulary are sometimes allowed under the Limited Use Program, according to the Immunodeficiency Clinic. A doctor with facilitated access must prescribe these drugs and add a special code to the prescription that indicates the patient and the drug being prescribed. If the medication does not qualify for this program, a doctor may apply for a specific patient to receive coverage for a limited time under the Exceptional Access Program.