Form For Prescription Drugs Previously Funded Through OHIP+ That Require Prior Authorization From a Private Insurer

On March 29, 2019 representatives from the ORA Board met with the MOHLTC to discuss the new OHIP+. The following information was shared by the Ministry:

Form for prescription drugs previously funded through OHIP+ that require prior authorization from a private insurer:

Q. My prescription drug that I used to get through OHIP+ is not covered by my private plan unless I get prior authorization. How can I ensure that there is no interruption in my treatment?
A. If you require a drug that was previously funded through OHIP+, including through the Exceptional Access Program and your private plan requires prior authorization before coverage will be provided, please ask your pharmacist to assist you in completing the “Pharmacy Confirmation Form for OHIP+ Transition of EAP Claims” located on the Ontario Pharmacists Association website at:
This form once completed and submitted to the private insurer along with a copy of a previous prescription receipt indicating that the drug was paid for by the government will help transition children and youth 24 years of age and under back to their private plan with little to no disruption in therapy.  Coverage for eligible drugs may be provided by the private plan for a period of time and patients should contact your private plan for more details. Please note that for coverage to continue after this initial approval, it is possible that patients may be asked to see their prescriber to have additional information submitted.