Understanding Ontario Revised OHIP+

Understanding Ontario’s Revised OHIP+ and What They Mean to Private Group Insurance Plans

The newly elected Ontario Conservative Government recently announced some major changes to the province’s OHIP program. Christine Elliott’s first official act as Ontario’s new Health and Long-Term Care Minister was to announce some major changes to the plan that would provide prescription drug coverage to anyone under the age of 25. The new policy creates a pharmacare program, establishing a second payer plan for younger Ontarians.

Providing access to essential medical treatments and medicine is something that’s essential to our country’s culture. The previous OHIP+ was rushed into existence on January 1st and was criticized by many Ontario citizens as a rushed attempt to create political gains for the now-ousted Wynn Liberal government. Many younger people already have prescription coverage via a private insurance plan. The existing healthcare plans for recipients of public provincial programs for people with disabilities or social assistance already provided drug coverage. Many found that their private coverage had more extensive pharmaceutical options with higher-quality drugs for chronic health conditions such as arthritis, epilepsy, and cystic fibrosis. The list of drugs covered by the public system was generally much smaller than the private plans many already accessed.

The OHIP+ plan did come with some positive changes such as providing free EpiPens for young people with life-threatening allergies, medications for people suffering from mental illness, and oral contraceptives for young women.

“Today, our government is announcing our intent to fix the OHIP+ program by focusing benefits on those who do not have existing prescription drug benefits,” said Christine Elliott, minister of health and long-term care, in a statement.

“Children and youth who are not covered by private benefits would continue to receive their eligible prescriptions for free. Those who are covered by private plans would bill those plans first, with the government covering all remaining eligible costs of prescriptions.”

Private insurance companies realized there were issues with the previous OHIP+ plan and continued to provide coverage until July 1st to allow the provincial government time to sort out any kinks. The newly designed Conservative plan is receiving positive feedback from parents and healthcare professionals, due to it’s increased coverage and a decrease in administrative work.

The Canadian Life and Health Insurance Association recently welcomed the update to the youth pharmacare program.

“The life and health insurance industry is committed to working with the government of Ontario to ensure a smooth transition and is pleased to extend the transition period agreed to with the previous government beyond July 1,” said Stephen Frank, president and chief executive officer of the CLHIA.”

“We will work closely with the new government to ensure that all those who are eligible for coverage under an employer-sponsored health benefits plan are transitioned back from the OHIP+ children and youth pharmacare program with minimal disruption.”

There are still many more details of the plan to be announced, but it’s clearly going to be more affordable for tax players. If people insured by private plans no longer make claims to the public plan, the cost will fall far below the estimated $500 million annual estimate.

Quebec is currently the only Canadian province with a universal pharmacare plan and does not allow a first-dollar model.

At Tanner Financial, we’ve been helping businesses throughout Greater Toronto area find the best group benefits package that suits their unique needs and budgets. We’re excited to see how the new Conservative Government’s public drug plan will impact how younger people are covered for prescription medicines. We have relationships with the nation’s most reputable insurance providers and we utilize these connections to get you the best insurance options that suit your needs. Contact one of our experienced GTA insurance advisors to learn more.

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