April 4, 2016 9:45 A.M.Ministry of Health and Long-Term Care
Ontario is making changes to the Ontario Drug Benefit (ODB) Program that will allow more than 170,000 seniors to become newly eligible for the low-income seniors program. As a result, they will save approximately $130 on average per year in out-of-pocket drug costs and almost half-a-million Ontario seniors will pay no deductible and only a co-payment of up to $2 per prescription.
Starting August 1, 2016, the government proposes to increase the income thresholds to qualify for the low-income seniors benefit:
● from less than $16,018 to less than or equal to $19,300 for single seniors, and
● from less than $24,175 to less than or equal to $32,300 for senior couples.
These new thresholds are aligned with the Ontario Guaranteed Annual Income System and will be indexed to ensure they remain aligned in future benefit years. With these changes, Ontario seniors will continue to enjoy the lowest on average out-of-pocket drug costs of any seniors across the provinces in Canada.
In addition to changes to benefit low-income seniors, the 2016 Budget also included proposed changes to drug cost contributions by non-low income seniors. Over the past month, the Province has consulted with Ontarians on these proposed changes and received feedback from seniors and representative organizations. Based on this feedback, the government is pausing the planned increases to drug cost contributions from seniors who are not low-income. Beginning this year the government will continue to consult on the correct income thresholds for an improved Ontario Drug Benefit, with a view to creating a fair, sustainable system that remains among the most generous in Canada.
Making drugs more affordable for low-income seniors is part of the government's plan to build a better Ontario through its Patients First: Action Plan for Health Care, which provides patients with faster access to the right care; better home and community care; the information they need to live healthy; and a health care system that is sustainable for generations to come.
- Since 1996, there have been no updates to the income thresholds for the ODB low-income seniors program and the co-payment and deductible for non-low income seniors, even though the cost to the government per senior has increased by nearly 130 per cent.
- With the proposed changes, in addition to the over 170,000 seniors who will be newly eligible for the low-income program as of August 1, 2016, approximately 30,000 additional new seniors would become eligible for the low-income seniors program each year.
- Seniors whose income continues to stay under the adjusted income threshold each year would continue to qualify for the $0 deductible and $2 co-payment.
- At present, there are over 4,300 drugs on the ODB Formulary. More than 1,000 drugs have been added since 2009 and 13 new drugs have been added since the 2016 Budget.
- Ontario will also publicly fund the shingles vaccine for seniors aged 65 to 70.