The senior’s Ontario Drug Benefit deductible and prescription co-payment
Learn how you can have the Ontario Drug Benefit annual deductible waived and co-payment fees reduced to $2 by applying for the Seniors Co-Payment Program.
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If you are a low-income senior with income below certain thresholds, you can have your Ontario Drug Benefit annual deductible waived and co-payment fees reduced to $2 by applying for the Seniors Co-Payment Program (SCP).
Who should apply
You should apply for the SCP if you have a valid Ontario Health card number, you are aged 65 years or older, and your annual net income is no more than either:
If you’re a single senior, with a yearly income of $22,200 or less after deductions, you pay up to $2 for each prescription drug filled or refilled – and you do not have to pay a deductible.
If you are a senior couple (where at least one person is aged 65 or older), with a combined yearly income of $37,100 or less after deductions, each senior over 65 years of age is eligible for benefits and pays up to $2 for each drug filled or refilled – and does not have to pay a deductible.
Only a spouse who is a senior receives drug benefits as a senior. A spouse who is under 65 years can apply to, or remain enrolled in, the Trillium Drug Program.
What is covered
The SCP helps cover the cost of approximately 5,000 prescription drugs that are currently available through the Ontario Drug Benefit program. If you meet the income thresholds, your annual deductible will be waived and co-payment fees reduced to $2 per prescription.
How to apply
To avoid unnecessary delays and ensure timely processing, complete the Seniors Co-Payment Program Application available on the Ontario Drug Benefit Program Online Applications and Forms website.
The online form will guide you through the application process to ensure all the information required for enrolment is provided before submission.
You may also refer to the SCP Guide to help you complete the application.
If you do not have access to a computer, you can also ask for the form to be mailed to you. You can request a paper copy of the SCP form and guide by:
- send an email to the SCP at email@example.com
If you have a spouse, the spouse’s information and signature must be included on your application, regardless of their age, or if they reside outside the province of Ontario.
You and your spouse (if applicable) must consent to the disclosure of income information from the Canada Revenue Agency (CRA) to the Ministry (“CRA consent”), regardless if you file an income tax return annually. This allows the Ministry to verify your household’s net income with the CRA electronically, which is the fastest way to determine your eligibility for the program.
If you or your spouse do not file an income tax return annually or a Notice of Assessment (NOA) is not available, then send us other proof of your income documentation with the application, such as:
- copies of all T4 or T5 slips with dates of earnings
- a copy of your T1 General (pages 1-8) or Special Tax Form with the disclosure section signed
- foreign government documentation equivalent to the Canadian notice of assessment (NOA)
- Canada Pension Plan (CPP) documents
- Employment Insurance (EI) documents
- Record of Employment (ROE) form
- Old Age Security (OAS) documents
- short- or long-term disability payment documents
- letter from employer(s) or accountant (if you are self-employed) showing your gross annual income or salary
- documentation from other income sources (Note: bank statements are not acceptable documentation)
- GST/HST Notice of Determination
- in the case of an applicant without any income, a letter declaring no income earned from any source for the applicable taxation year signed and dated by the individual making the declaration
After you are enrolled
Once you are enrolled in the SCP, you will receive a confirmation letter with your coverage start date and the member(s) who are enrolled. Note: If your spouse is under 65 years of age, they will not be eligible for the SCP until they turn 65.
You do not need to re-apply every year, if your household’s income has been verified by the CRA.
If you are enrolled based on another proof of income listed above, you will need to provide the updated income documentation to SCP each year.
What you pay
Once enrolled in the SCP program, you pay no annual deductible and a reduced co-payment of $2 for each eligible prescription filled.