To: OSSTF Members
From: Donna Morrison, Executive Director
April 2, 2019
The Ontario government is making changes to OHIP+ starting April 1, 2019.
OHIP+ was implemented by the Ontario Government effective January 1, 2018 to provide drug coverage for Ontario residents who are 24 years old or younger. Starting April 1, 2019 if individuals who are 24 years old or younger who have drug coverage under a private insurance plan, such as the OSSTF Benefits Plan, will no longer be eligible for OHIP+ and drug claims will need to be submitted to the private plan.
This means that starting April 1, 2019 pharmacists need to be advised that for eligible members or dependents who are 24 years old or younger who have Extended Health Care Benefits through the OSSTF Benefits Plan, drug claims should not be submitted to OHIP+ but rather the OSSTF Benefits plan.
Affected OSSTF members will be receiving a communication from OTIP to advise of this change and outline additional steps that may need to be taken at the pharmacy for drug claims incurred on or after April 1, 2019. This communication will also provide information about specialty drugs that may require prior authorization in order to be eligible for reimbursement under the OSSTF Benefits Plan.
Additional information on this change will also be posted on otip.com/news with a link to the Ontario government’s official announcement and FAQs.
The financial impact of this change is being monitored by the OSSTF Benefits Board of Trustees, as the anticipated savings to the OSSTF Benefits Plan because of the implementation of OHIP+ will no longer apply which will mean that the cost of drug claims under the OSSTF Benefits Plan will be higher than anticipated.
This communication will be posted on www.OSSTFBenefits.ca for future reference.
Questions about this notice? Please contact Donna Morrison directly at
donna.morrison@osstfbenefits.ca.
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