Trillium Drug Program
What is the Trillium Drug Program (TDP)
The Trillium Drug Program (TDP) is an annual provincial government program for residents of Ontario who have a valid Ontario Health Card and spend a large part of their income on prescription medications. The TDP provides benefits for certain prescription drugs when drug costs for a household are higher than approximately four percent of the household income or total net household income.
What Prescription Drugs are Covered?
The TDP provides coverage for prescription drug products listed on the Ontario Drug Benefit Formulary/Comparative Drug Index (Formulary) including:
• Over 3,800 quality-assured prescription drug products;
• Over 450 limited-use drug products (see “Your Benefits”)
• Some nutritional products and diabetic testing agents;
• Approximately 850 drug products not listed on the Formulary. Must receive prior authorization through EAP
(see “Your Benefits”)
Who can Apply
You should apply to the TDP if:
• Your household spends a large portion of its income on prescription drugs, and
• You have a valid Ontario Health Card, and
• Your household does not have private insurance plan that covers prescription drugs, or your private insurance plan does not cover all the costs of your household’s prescription drugs
What is a “Household” for the Purposes of the TDP?
Enrolment in the TDP is based on a “household”. A household is a single person or two or more people who are dependent on each other financially. For the purposes of TDP, the following people are included in the definition:
• A single person living along;
• A spouse, common-law or same-sex partner;
• Children, parents or grandparents who live with you and rely on you or you on them for financial support; and
• Children who are students, who may not live with you but rely on you financially, such as students who are away for school or living abroad.
How to Apply
Step 1: Complete the Application Form before the Deadline
Step 2: Provide Two Signatures for each Person 16 and over
Step 3: Include Documents if Applicable
Step 4: Mail Completed Application before the Deadline
After you are Enrolled: What Costs will you Pay? What is the Deductible?
Before you can receive TDP drug benefits, you must pay yourself for a set amount of prescription drugs. This “set amount” is called the deductible. The deductible is approximately 4% of the total household net income and is calculated annually, based on the number of people in your household and the combined net incomes.
When your eligible prescription purchases equal the amount of your deductible for that quarter, your TDP benefits begin, and you will only pay up to $2 for every ODB eligible prescription until the next quarter.
Your Benefits
The TDP provides coverage for prescription drug products listed on the Ontario Drug Benefit Formulary/Comparative Drug Index (Formulary) We strongly recommend that you consult your doctor or pharmacist to confirm that your prescription drugs are eligible for coverage before your prescription is dispensed.
Limited Use: Some drugs covered in the Formulary are classified as Limited Use (LU) and are only eligible for TDP benefits under certain conditions. For these drugs, your prescribing doctor must use a Limited Reason For Use Code on the prescription form
Exceptional Access Program (EAP): Coverage may be provided for a prescription not listed in the Formulary, however prior approval is obtained through the EAP. Doctors must make a written request on your behalf. There is no guarantee coverage will be approved.
General Information
TDP Benefit Year: August 1 to July 31
Dates for Deductible:
First Quarter: August, September, October
Second Quarter: November, December, January
Third Quarter: February, March, April
Fourth Quarter: May, June, July
Links
For program information: http://www.health.gov.on.ca/en/public/programs/drugs/programs/odb/opdp_trillium.aspx
To download an application: http://www.health.gov.on.ca/en/public/programs/drugs/opdp_forms.aspx
By Phone:
Hours: Mon to Fri, 9am – 5pm
416-642-3038
1-800-575-5386 (toll free)
1-800-387-5559 (TTY)
