Trillium Drug Plan
What is the Ontario Trillium Drug Plan?
This plan was put in place to address expensive prescription drug costs for people who qualify for Ontario Health Insurance (OHIP) and have chronic health conditions but are not covered by Ontario Disability Support Plan (ODSP) or Ontario Works (OW). This has been extended to cover people at risk for HIV by covering PrEP. Trillium covers a portion — but not all — of your drug costs. It is intended to help working people afford the cost drugs.
How Does the Ontario Trillium Drug Plan Work?
If a person needs $10,000 worth of drugs annually and earns $50,000 per year, their deductible is 4% of their household income, which equals $2,000. Trillium pays the difference of $8,000.
Trillium operates quarterly, and the deductible is spread out over the course of one year. If your annual deductible is $2,000, then your quarterly deductible will be $500.
Therefore, the individual is responsible for the first $500 per quarter, plus an additional $2 per drug dispensed. Trillium covers the rest of the drug costs for that quarter. The process begins again every three months.
Things to know before applying for Trillium
Trillium applies to prescriptions filled in the province of Ontario, ONLY.
Trillium covers a wide range of medications, including most HIV Medications like Truvada and Atripla, as well as many generics; however, Trillium will only cover medications listed in the formulary. Always make sure the drug you need is listed before applying. Note: generic PrEP is on the formulary.
Registering for Trillium requires that you register your entire household, regardless of whether any of those other people require drugs. A ‘household’ does not include adults who live together but are financially independent (e.g. roommates).
Make sure your health card is valid and up-to- date. Your health card is what your pharmacist will use to ensure that you are enrolled with Trillium, and that your costs are billed to the province instead of to you.
How to Apply to Trillium
Click here for a guide to applying to the Ontario Trillium Drug Benefit Program.
Applications for trillium can be found online here.
Please note the above link can only be accessed via Internet Explorer. You must have Adobe Reader 8 installed. Using any other browser such as Microsoft Edge, will fail to load the document.
You can also apply by calling 1-800- 575-5386 or in person at a pharmacy.
On average, applications take two weeks to one month to be processed.
Trillium Drug Coverage Example: Alex
- Alex makes $50,000 after taxes
- His prescription drugs cost $12,000/year, or $1000/month
- 4% of his net income is $2000
- Alex will pay $500 quarterly (plus an additional $2 per prescription paid to the pharmacist). Trillium pays the rest.
- Remember: The benefit year begins in August
Quick Start Guide
1. Assess your eligibility
To be eligible for Trillium you need:
- To have filed taxes the previous year or are ready to submit proof of income
- Have OHIP coverage – a valid Ontario Health Card
- No drug coverage, or partial coverage
- High drug costs
2. Calculate your deductible.
Your deductible is 4% of your net income. Click here to check out the Trillium Drug Plan Calculator to determine your deductible.
3. Fill out an application form here.
Please note the above link can only be accessed via Internet Explorer. Using any other browser such a Microsoft Edge, will fail to load the document. If you do not have Internet Explorer, we have attached a PDF version of the Ontario Trillium Drug Application on this page to help you access this form.
* Download PDF to computer and open with Adobe Reader to view/edit
Ensure that all the members of your household sign and consent to Trillium obtaining their tax records from the CRA and choose a start date that begins one day before you plan to fill your first prescription, or immediately, if you need drugs right away. Trillium will reimburse you.
4. Purchase medications from your local pharmacy as usual, once you are enrolled.
You will be responsible for ¼ of your deductible amount each quarter, plus $2 (dispensing fee) for each medication. Trillium will cover the rest. You must present your health card each time you wish for Trillium to cover medications.