Ontario Health Insurance Plan (OHIP+): Children and Youth Pharmacare update

Effective January 1, 2018, Ontario residents 24 years old or younger will be able to receive some prescription medications for free under the new OHIP+ Children and Youth Pharmacare program. Medications currently on the Ontario Drug Benefit Formulary and eligible Exceptional Access Drugs may be covered.

What it means for you as a University employee:

  • The Province of Ontario will be considered “first payer”.  This process will be administered at the Pharmacy so you should not have to do anything.
  • If the Province requires you to take additional measures, you will be advised by either your doctor or pharmacy with respect to what you should do.
  • If the Province denies the coverage, the University will continue to offer the coverage through your normal plan in the capacity as a “second payer”. 

Here are the steps being taken by the Ontario government and Manulife to ensure you have as much information as possible before the new program takes effect.

  • Manulife will be contacting plan members (via email and regular post) who may be affected by OHIP+ about the actions they need to take, so they (or their dependants) have uninterrupted access to their prescription drugs.
    • Manulife will be sending its messages using the contact information it has on file. If you are concerned that Manulife does not have up-to-date contact information, check the address on record for you at the University. To update your address, visit My HR Profile.
  • Plan members or dependants affected by OHIP+ (24 years old or under):
    • must submit all eligible drugs claims to OHIP+ for payment (if OHIP+ does not cover the entire cost, the claim may be eligible for coverage under the member’s Manulife Benefits plan)
    • may need to visit their prescribing doctor before getting covered by OHIP+
    • may need to get approval from the Ontario Ministry of Health and Long-Term Care  (MOHLTC) for their prescription claims under OHIP+ (if such claims are declined, they may be eligible for coverage by Manulife)

OHIP+ has provided full details of the new program, including several fact sheets you can review in advance of the program’s effective date:

Manulife is working closely with the Ontario Ministry of Health and Long-Term Care to get more information about the guidelines and the impact on your coverage. Check the Manulife plan member message centre on the for OHIP+ updates. Log in to the Manulife secure website.

Should you have any questions, contact Manulife at 1-800-268-6195.

Back to top