Personal Finance

Applying for the Ontario Trillium Drug Benefit

  • Last Updated:
  • Apr 28th, 2014 9:46 pm
[OP]
Newbie
Oct 30, 2013
2 posts

Applying for the Ontario Trillium Drug Benefit

I was thinking about applying for ODB because I have high medical expenses and my current health insurance provider (a group benefit from my school) doesn't cover all my prescriptions. I haven't been consistent with purchasing them because when I verify with my insurance company they say they'll cover 80%, then when I get to the pharmacy they say they won't cover it at all. So right now I'm paying for what I can and missing whole months of treatment. I was looking at the application and guide and was wondering if I would need to have already purchased all my medication when I apply or is it sufficient to show them the prescription for the ones I haven't gotten filled?, seeing as the total for the ones I have purchased so far this year falls below 4% of my income.
4 replies
Deal Guru
User avatar
Mar 31, 2008
10806 posts
1731 upvotes
Toronto
It's based on income. So you would have to get approved first from my understanding. Not after you have gotten the medicine and that it's too much that you spent.
Deal Addict
Jan 28, 2014
3095 posts
480 upvotes
at1212b wrote:
Apr 28th, 2014 4:16 pm
It's based on income. So you would have to get approved first from my understanding. Not after you have gotten the medicine and that it's too much that you spent.
Agreed. If you go to the ODB website, it will guide you through the process to the Trillium program. You will need approval after a review of your income, current coverage and your health issues. I saw it when I was looking up the ODB for my husband since he turned 65.
Sr. Member
Sep 24, 2006
865 posts
40 upvotes
Go apply first, based on your income you will have to pay a deductible, everything after that deductible will be covered so long as its on the ODB formulary.

Source: I work at a pharmacy
Sr. Member
Jun 12, 2008
741 posts
180 upvotes
Ripley
RoxA056 wrote:
Apr 28th, 2014 3:55 pm
my current health insurance provider (a group benefit from my school) doesn't cover all my prescriptions. I haven't been consistent with purchasing them because when I verify with my insurance company they say they'll cover 80%, then when I get to the pharmacy they say they won't cover it at all.
Who did you verify coverage with at the insurance company? I would call right before I went to the pharmacy noting names, and them calling again when the insurance company declines it at the pharmacy.

Are you supposed to mail in your receipts for reimbursement? With my husband's previous coverage we had to pay 100% of the cost at the pharmacy and then send the receipts to the insurance company.

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