Update to OHIP+ Coverage

Claims, Insurance & Taxes

The Ontario government has announced that effective April 1, 2019, OHIP+ Children and Youth Pharmacare will only be available to those Ontario residents under the age of 25 that do not have private insurance drug plans.

Starting Apr. 1, 2019

Prescription drug coverage for you or your dependent, as an Ontarian under the age of 25, will revert to your group benefits plan with The Co-operators.

All plan design features included in your prescription drug coverage, such as co-insurance, co-pays, drug maximums and the list of covered drugs, will apply.

OHIP+ is not second payor. Any out-of-pocket amounts can be coordinated with another private insurance plan.

Where to find Prior Authorization forms

Our Prior Authorization forms are conveniently located online at www.cooperators.ca or on our Benefits Now® for Plan Members portal.

How to avoid disruption in coverage

If you or your dependent are currently taking a drug that requires prior authorization by The Co-operators, we recommend that you follow up with your prescriber to complete The Co-operators prior authorization forms.

Forms should be returned to us before Oct. 1, 2019, so that we can assist you in a seamless transition.

Trillium Drug Program

Individuals or families in Ontario who experience significant out-of-pocket expenses can apply to the Trillium Program (an income-based plan with an annual deductible) for consideration of excess out-of-pocket costs.

For more information on the Trillium Drug Program, please visit: www.Ontario.ca/page/get-help-high-prescription-drug-costs.

Do You Have More Questions?

Contact our Group Client Service Centre by telephone at 1-800-667-8164 or through our “Ask a Question” option on Benefits Now®.

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