OHIP+: Prescription Coverage for Ontarians 24 and Under

Current as of October 2026. Government programs, tax rules and prices change. Check the official sources listed at the end of this page before making a decision, and confirm details with a licensed advisor.

What OHIP+ is

OHIP+ (Ontario Health Insurance Plan Plus) is the province's prescription drug coverage for children and youth. As of October 2026, the Government of Ontario says it applies to people who are 24 years old and under, have OHIP coverage, and are not covered by a private plan. There is nothing to sign up for: eligible young people are covered automatically.

Think of the everyday moments it shows up: an antibiotic for a child's ear infection, a teenager's asthma inhaler, insulin for a university student. If the young person qualifies, they bring a prescription and their health card (or health card number) to any Ontario pharmacy, and as of October 2026 Ontario says the pharmacy fills eligible medications at no charge.

OHIP+ sits alongside other public programs. For a wider look at what the province pays for, see what OHIP covers and our overview of government health programs and employer benefits.

Who qualifies, as of October 2026

According to Ontario's official OHIP+ page, as of October 2026 a person is covered when all of the following are true:

Coverage is limited to medications on the provincial list, so a prescription for a drug that is not listed will not be paid for by OHIP+.

• They are 24 years old or younger.
• They have OHIP coverage.
• They are not covered by a private plan (for example, a parent's employer benefits, their own workplace plan, or an individual plan).

What "covered by a private plan" means

This is where OHIP+ meets employer benefits. Since April 1, 2019, OHIP+ has been focused on children and youth who do not have a private plan. Young people who do have one are expected to fill prescriptions through that plan instead.

The Ministry of Health's questions and answers for pharmacists define a private plan broadly: an employer, group or individual plan, program or account that could be used for drug coverage. That wording includes health spending accounts, so a dependant covered only by an HSA is still considered to have a private plan.

The same ministry guidance makes a few other points that surprise families:

• Eligibility does not depend on whether the private plan covers the specific drug. If the young person has a private plan, they are not eligible for OHIP+, even for a drug that plan excludes.
• A co-payment, deductible or premium on the private plan does not restore OHIP+ eligibility, and neither does reaching the plan's annual maximum.
• There is no coordination of benefits between OHIP+ and private plans. OHIP+ does not act as a second payer to pick up what the employer plan leaves behind.

What OHIP+ covers

As of October 2026, Ontario says OHIP+ covers more than 5,900 medications. The province's examples include antibiotics, asthma inhalers, insulin, epinephrine auto-injectors and ADHD medications. Drugs available through the Exceptional Access Program may also be covered on an individual basis.

Ontario also lists smoking cessation support: up to a year of pharmacist-assisted counselling, plus related medications for people 18 and over. Lists and program details can change, so check the current list on ontario.ca or ask a pharmacist before assuming a specific product is included. For context on the broader formulary, see our page on the Ontario Drug Benefit program.

How OHIP+ interacts with employer drug coverage

For employers, the practical takeaway is simple: if your group plan covers employees' dependent children, those children generally use your plan for their prescriptions, not OHIP+. Your plan's design (drug formulary, co-insurance, deductibles, annual maximums) decides what a parent pays at the pharmacy counter. That makes prescription drug benefits and dependent coverage worth reviewing together.

The ministry's guidance also notes that if a child or youth is not covered by any private plan, for example because the parents have opted out of dependent coverage, the young person would qualify for OHIP+. Whether opting out makes sense is a family decision with trade-offs, since group plans often include much more than drugs: dental cleanings, new glasses, physio after a sports injury. Group plans also have their own rules about when and how members can waive or change coverage, so employees should check their plan booklet and HR before changing anything. Our guide on opting out of group benefits covers the general considerations.

Young employees matter here too. A 22-year-old on your payroll who enrols in your plan is covered by a private plan, so their prescriptions run through your benefits rather than OHIP+.

When high costs or other programs come into play

OHIP+ coverage stops on a person's 25th birthday, as of October 2026. After that, Ontario says other financial help with prescription costs may be available.

For families who do have a private plan but still face significant out-of-pocket prescription costs, the ministry points to the Trillium Drug Program, which, as of October 2026, is designed for people whose prescription costs are high compared to their household income. Ontario also says that young people in Ontario Works or the Ontario Disability Support Program continue to receive drug coverage through those programs, whatever their private plan status.

Rules for all of these programs can change. Always confirm current details on ontario.ca before making plan or family decisions.

Talking it through with an advisor

If you are designing or renewing a plan, an advisor can explain how dependent drug coverage, deductibles and maximums affect families on your team, and how your plan sits next to public programs like OHIP+. GroupBenefitPlans.ca does not sell insurance or give advice itself. When you are ready, get matched with a licensed benefits advisor who can walk you through the options.

Common questions

Do I need to apply for OHIP+?

No. As of October 2026, Ontario says there is no need to enrol or register. Eligible young people show their health card or health card number with a prescription at any Ontario pharmacy.

My child is on my work benefits but the plan does not cover their medication. Can OHIP+ pay for it?

Generally no. Ministry guidance says OHIP+ eligibility does not depend on whether the private plan covers the specific drug, and there is no coordination of benefits between OHIP+ and private plans. Families with high out-of-pocket costs can look into the Trillium Drug Program.

Does a health spending account count as a private plan for OHIP+?

Yes. The ministry's definition of a private plan includes any account that could be used for drug coverage, such as a health spending account.

What happens to OHIP+ coverage at age 25?

OHIP+ stops on the person's 25th birthday, as of October 2026. They may then rely on a workplace or individual plan, or check whether other provincial programs can help with prescription costs.

Does OHIP+ charge a co-payment or deductible?

As of October 2026, Ontario says pharmacies fill eligible prescriptions at no charge for people who qualify for OHIP+. Coverage is limited to eligible medications on the provincial list.

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