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Ontario Provincial Health Insurance Plan: Fact Sheet

Prescription Drugs

■ Coverage under the Ontario Drug Benefit Plan Program for seniors and Social Assistance recipients only. Covers drugs listed on the Ontario drug formulary. Seniors must pay the first $100 in prescription costs. Once this has been satisfied, seniors must pay the first $6.11 for each prescription.
■ Catastrophic coverage under the Trillium Drug Program after a deductible (paid in quarterly installments) has been satisfied. The deductible is based on family net income. Once this has been satisfied, households must pay up to $2.00 for each prescription.


■ Coverage for in-province land and air ambulance when deemed medically necessary. Patient is responsible for a $45 co-payment. Some exemptions apply.

Dental Benefits 

■ No coverage for routine dental care.
■ Coverage for some dental surgery when it is done in hospital.

Eye Care Services 

■ Coverage for regular eye exam every 12 months for those aged 19 and under and seniors aged 65 and over.
■ Coverage for regular eye exam every 12 months for those aged 20 to 64 with medical conditions affecting the eye.


■ Coverage for standard ward rooms only.


■ No coverage for chiropractor, psychologist, massage therapy or naturopath services.
■ Coverage for podiatrist services up to an annual maximum of $135. An additional $30 per plan year is available for x-rays.
■ Coverage for speech therapy when performed in hospital only.
■ Coverage for physiotherapy for seniors aged 65 and over, individuals age 19 and under and individuals of any age needing physiotherapy after being hospitalized.

Hearing Aids 

■ The Assistive Devices Program covers 75% up to a maximum of $500 of the cost one hearing aid, if eligible.
Simply dial 416-835-8805 for details.
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