Ontario

The Ontario Health Insurance Plan: What OHIP covers

Ontario Public Drug Programs: Ontario Drug Benefit Program: You will qualify for the Ontario Drug Benefit (ODB) program when you turn 65 years old. You can qualify before you reach that age because you’re:

• • Living in a long-term care home, home for special care, community home for opportunity 
  • 24 years of age or younger and not covered by a private insurance plan
  • Receiving professional home and community care services
  • Receiving benefits from Ontario Works or Ontario Disability Support Program
  • Enrolled in the trillium drug program 

The ODB is for Ontario residents only and prescriptions must be filled in an Ontario pharmacy to be covered. You must ensure your Ontario health card is valid. The Ontario Drug Benefit program covers most of the cost of approximately 5,000 prescription drug products. For more information, click here.

The Trillium Drug Program: The trillium drug program (TDP) is an annual provincial government program for Ontario residents with a valid Ontario health card who spend a large portion of their income on prescription medications. The TDP is not designed to replace private insurance plans or drug benefits provided by the government of Ontario, including Ontario Works, Workplace Safety and Insurance Benefits (WSIB), Home Care, Ontario Disability Support Program (ODSP) benefits. You are able to apply to the program if you have no private drug insurance coverage or in the case where your drug costs are only partially covered by your private insurer.

Verspeeten Family Cancer Centre – Patient Assistance Program (London, Ontario area only) If you are undergoing treatment within the Verspeeten Family Cancer Centre and its affiliated regional sites you may be eligible to apply for financial assistance. Funding is available for emergency, short-term situations when funding from other sources and services is not available. The funding can be used for various expenses such as wigs, prostheses and bras, child care during treatment, and supportive medications to treat symptoms related to treatment.

Ontario Works: Ontario works offers assistance to people in temporary financial need, through providing funds to cover living expenses and help finding employment.

Emergency assistance: This program helps to provide basic needs like food and housing for individuals in emergency situations and are not already receiving support from Ontario Works or the Ontario Disability Support Program.

Low-income workers tax credit: This tax credit is for individuals earning a low income, including those who earn minimum wage. It can be used to reduce or eliminate your Ontario personal income tax.

Ontario Guaranteed Annual Income Support (GAINS): This program provides eligible low income Ontario seniors with a monthly non taxable payment.

Northern Health Travel Grant Program: The Northern Health Travel Grant (NHTG) program offers financial support to Northern Ontario residents who have to travel long distances for specialized medical services or procedures at a ministry-funded health care facility. For eligible applicants, travel grants are based on the distance you need to travel to reach the nearest medical specialist or ministry funded health care facility that can provide the needed health care services without delay. To qualify, you need to have traveled at least 100 kilometers (km) one-way to access the closest medical specialist or ministry-funded health care facility services that are not available locally and you need to submit your NHTG application to the Ministry of Health (MOH) within 12 months of the date of treatment. For more information about the Northern Health Travel Grant Program, click here.

Transportation – Hamilton: The Cancer Assistance Program’s Drive & Ride program provides residents of the Greater Hamilton Area a safe ride with door-to-door service to and from all cancer-related appointments. CAP volunteers have been screened and trained. You will either be transported in a CAP van or a volunteer driver’s personal vehicle.

Parking: The Cancer Assistance Program provides limited parking spaces in a private lot at Sacred Heart Parish Centre within walking distance to the Juravinski Cancer Centre in Hamilton. You are required to obtain your own personal parking permit from the CAP office and call to reserve your spot before each appointment.

Feed Ontario: The province’s largest collective of hunger-relief organizations. Using this link, you can find your nearest Feed Ontario member food bank by searching with your postal code or address.

Ontario Disability Support Program: Managed and delivered by the Ministry of Community and Social Services, provides financial help for people with disabilities. It can help pay for living expenses, like food and housing.

You may qualify for income support if you:

• are in financial need
• are 18 years of age or older
• live in Ontario, and
• have a substantial physical or mental disability that: is expected to last a year or more, and makes it hard for you to care for yourself, take part in community life or work.

The amount of income support you receive will depend of your:

• family size
• Income
• assets, and
• housing costs

If you qualify for income support, you and your family may also qualify for other benefits, such as:

• drug coverage
• dental coverage
• vision care 
• transportation to medical appointments

For more information on the Ontario Disability Support Program, click here.

The Pediatric Oncology Group of Ontario offers financial support to families with a child undergoing cancer treatment. They can provide assistance with some of the costs of accommodation, food, and child care.

Hayden’s Hope Foundation (assist pediatric oncology families in SW Ontario requiring financial support for travel costs and mental health): Hayden Hope’s Foundation is now accepting applications from pediatric oncology families in Southwestern Ontario requiring financial support. There are two categories of funding available:

Family travel supports:

• This program funds pediatric oncology families living in Southwestern Ontario who are travelling away from their home hospital for CAR T-cell therapy or bone marrow transplant. It also funds pediatric oncology families living in Southwestern Ontario who show a one-time exceptional need.
• Funds covered include costs associated with living away from home up to $1,000 annually (e.g. Ronald MacDonald House, hotel, groceries, parking food vouchers) and access to volunteers to run errands in London, Toronto, Windsor and Mount Forest (e.g. grocery pick-up)

Mental health support for parents/caregivers: 

• This funds pediatric oncology parents and caregivers living in Southwestern Ontario accessing mental health and wellness supports. $500 is available per eligible family per year.  
• Funds covered are meant for mental health supports including psychologists and clinical counselling, general health and wellness costs including physical therapy, massage, acupuncture, gym membership, etc.
• For information on how to apply for either category of funding, click here.

Jennifer Ashleigh Children’s Charity:  Jennifer Ashleigh Children’s Charity works closely with hospitals and rehabilitative centers across Ontario to identify, screen and support families whose lives have been turned upside down following a critical medical event that has occurred with their child. They can help with accommodation costs, transportation expenses, essential housing support (rent/utilities), meal support, prescription medications not covered by OHIP or extended health benefits, disposable medical supplies not covered by government programs or insurance, specialized equipment, assessment and session fees for rehabilitative therapy, sibling childcare, 1:1 respite care. For more information, including on qualifying criteria, and application requirements, click here. 

Financial Support — Childcan: After receiving a childhood cancer diagnosis, a family will be referred to Childcan by Children’s Hospital or the Paediatric Oncology Satellite Clinic. This allows support to begin right away. A package of information and resources is given to each newly diagnosed family. The packages include:

• A detailed explanation of all programs and support services offered by Childcan;
• A Children’s Hospital parking pass to cover parking costs for the entire time their child is on active treatment;
• Gas, restaurant, or other gift cards to help with immediate costs of treatment; and
• Information about other available support resources

Childcan also has four programs to provide support, including a parking pass program, a family meal voucher program, a family financial assistance program, and a treatment-related travel program. Note that the services Childcan provides are for families who have been diagnosed and/or are being treated at Children’s Hospital, LHSC and/or Windsor’s satellite clinic.

For more information, click here.

The Ontario Energy Board (OEB) provides programs to assist with energy bills:

• Low-income energy assistance program: If you are experiencing challenges paying your electricity or natural gas bill, you may be able to receive support through the Low-Income Energy Assistance Program (LEAP).
• Ontario Electricity Support Program: The Ontario Electricity Support Program is designed to lower electricity bills for low-income households.

The Assistive Devices Program (ADP) is part of the Ontario Ministry of Health and Long-Term Care ADP contributes towards the cost of medical equipment including breast prostheses and compression garments for primary or chronic (secondary) lymphedema. You are able to apply for assistance if you are an Ontario resident, have a valid OHIP card and.

Lymphedema Garments: To qualify, you must require a device or garment for at least six months of regular daily use. ADP forms can be accessed through a medical specialist, such as an oncologist or plastic surgeon. Your specialist will also refer you to an authorizer to assess your specific needs and prescribe the appropriate equipment or supplies. An “authorizer” may be an occupational therapist or physiotherapist registered with ADP.

For Either Lymphedema Garments or Prostheses: Purchase of your required equipment must be from a vendor registered with ADP. As long as the cost of your item does not exceed the maximum set by ADP, you will pay approximately 25 per cent of the cost and ADP covers the remaining 75 per cent.

Prosthesis. To qualify, you must have a long term disability requiring permanent use of prosthetic breasts (s). ADP will contribute to the cost of external silicone breast prostheses for individuals who have had a mastectomy or lumpectomy. It will not cover temporary use (such as fibrefill), increasing breast size (augmentation), skeletal deformities (such as scoliosis), transition in gender identity. To apply for a breast prosthesis, (1) find a retailer with staff that are trained/certified to fit people with breast prostheses, (2) buy the prosthetic (s). You must pay the full cost before submitting your application (it is advised to keep the receipt for 2 years), (3) fill out the application form, (4) mail the completed form to: Assistive Devices Program 7th Floor, 5700 Yonge Street
Toronto, Ontario M2M 4K5. For more information, click here.

 

For Either Lymphedema Garments or Prostheses: Purchase of your required equipment must be from a vendor registered with ADP. As long as the cost of your item does not exceed the maximum set by ADP, you will pay approximately 25 per cent of the cost and ADP covers the remaining 75 per cent.

• Replacement: 
  • For garments, if you qualify, and your application is approved, you will receive replacement garments for 2 years as needed. After that 2 year period, you must reapply and get re-examined. The ADP does not cover costs to replace a lost or damaged garment. 
  • You can apply to replace a breast prosthesis you originally purchased through the ADP. The replacement must be needed because of a change in your body size/shape or a change in your medical condition or because of normal wear to a prosthesis that is no longer covered under warranty. The ADP does not cover costs to replace a lost prosthesis or to repair prostheses damaged through misuse or neglect.

Other Programs for Assistive Devices: If you are unable to afford to pay your share of the cost, you can contact the following volunteer and charity organizations about additional financial assistance:

• Easter Seals Ontario
• March of Dimes Canada
• The War Amps
• Kiwanis
• Lions Clubs
• Services – Cancer Assistance Program

Money Matters by Wellspring Cancer Support is a case management program that offers assistance to people with cancer and their family members with information and resources about various financial topics.

CancerCare Ontario: CancerCare Ontario reimburses hospitals for administration of injectable cancer drugs used according to established funding criteria for patient eligibility. Their drug reimbursement programs are administered by the Provincial Drug Reimbursement Programs (PDRP)