July 3, 2018
The Ontario Conservatives have rewritten the OHIP+ program for Ontarians under 25 years of age. The new Minister of Health and Long-Term Care, Christine Elliot, has put into effect a 180-degree flip flop for private payers. Whereas the Liberals had mandated the government to be the first payer for all residents in this age group, the Conservatives have reversed this so that private payers will take back that role of first payer for under 25’s. Only children and youth who are not covered by private benefits will receive their drugs through the government plan, if they are one of the 4,400 drugs listed on the Ontario Public Drug Plan formulary. The timing for the implementation of this change has not yet been announced.
Insurance companies were just getting used to the administrative requirements for ensuring all those 24 years and under were reimbursed first by the public purse. It is likely, many insurers had started to project savings from the original OHIP+ program, and possibly how these savings would be passed along to plan members. All this will now reverse. Although there may be confusion with this flip-flop, this should reduce the burden on the tax payer, while at the same time continue to ensure those 24 and under are granted their necessary medicines (at least those listed).
For more information, please contact Marla Weingarten at firstname.lastname@example.org, Consultant, The Pangaea Group.