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SilentKnight

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#1

Goddamn OHIP!

07-12-2009, 07:32 AM

Recently, my diabetic father learned that OHIP (Ontario Health Insurance Plan) is no longer covering an important diabetic medication he's been taking for several years.

OHIP gave him no notification or advance warning they were dropping coverage of the medication. He didn't find out until visiting his local pharmacist for a prescrip renewal this past Friday.

Now my retired father on a fixed retirement income has no choice but to come up with $300+ each month to pay for the meds, when in the past he simply had to pay the $26 dispensing fee at the pharmacy.

The woman he spoke with over the pharmacy counter told him the provincial gov't had recently canceled converage on a large number of medications needed by seniors.

She then commented that the cancellation of coverage coincided with the timing of the General Motors bailout.

WTF?!
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jay23

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#2

07-12-2009, 07:36 AM

Originally posted by SilentKnight

Recently, my diabetic father learned that OHIP (Ontario Health Insurance Plan) is no longer covering an important diabetic medication he's been taking for several years.

OHIP gave him no notification or advance warning they were dropping coverage of the medication. He didn't find out until visiting his local pharmacist for a prescrip renewal this past Friday.

Now my retired father on a fixed retirement income has no choice but to come up with $300+ each month to pay for the meds, when in the past he simply had to pay the $26 dispensing fee at the pharmacy.

The woman he spoke with over the pharmacy counter told him the provincial gov't had recently canceled converage on a large number of medications needed by seniors.

She then commented that the cancellation of coverage coincided with the timing of the General Motors bailout.

WTF?!

My father is diabetic (and on OHIP) and I am Diabetic too but live in US.

95% of the meds are covered, some new or more exotic (like delay release) are not. Same in US even if you have the best insurance.
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SilentKnight

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#3

07-12-2009, 07:37 AM

Originally posted by jay23

My father is diabetic (and on OHIP) and I am Diabetic too but live in US.

95% of the meds are covered, some new or more exotic (like delay release) are not. Same in US even if you have the best insurance.

Not sure if this is a delay release med, but its one he's been taking for several years that was previous covered by OHIP.

I'll be talkin' with him later today - perhaps find out more specifics from him.
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evildick
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#4

07-12-2009, 07:42 AM

Good old McGuinty.
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ottyhotties

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#5

07-12-2009, 10:04 AM

Good luck. Hope your Dad finds a new medication without him having to shell out $300 a month. It could take days and/or weeks and a lot of long lines to figure this all out, but hopefully he can get this figured out before shelling out another $300 out of pocket. I can't imagine diabetic medicines not having some kind of a replacement.
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BlackCrayon

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#6

07-12-2009, 10:19 AM

there is a program in Ontario called Trillium that will cover most medications needed. It might not help as most people who use it, i assume are under 65 as its a way for older people with low income to be able to afford their meds but it might be something worth looking into.

you don't know you're wearing a leash if you sit by the peg all day..
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fris

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#7

07-12-2009, 01:17 PM

$26 dispensing fee? god why oh why, goto walmart its like $8

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SilentKnight

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#8

07-12-2009, 04:35 PM

Originally posted by BlackCrayon

there is a program in Ontario called Trillium that will cover most medications needed. It might not help as most people who use it, i assume are under 65 as its a way for older people with low income to be able to afford their meds but it might be something worth looking into.

Hmm...I'll mention that to him - might be something to look into.

For now he has to wait until tomorrow morning to contact OHIP again and find out some additional info about what's happening with the coverage.

Thanks BC.
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Mrs F.U.B.A.R.

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#9

07-12-2009, 04:58 PM

have your dad look into Trillium.... it's a plan through the government of Ontario (outside of normal OHIP) that helps to cover required meds for long term and chronic illnesses... it's based on income and helps to cover very necessary drugs that people would other wise have to do without... I know someone who has used it for drugs for MS that would have otherwise cost $1800 a month... they also help cover other drugs not just for MS... he should ask about it anyway... if they don't cover that particular drug he needs to check with his doctor and see if he could go on another one that would work as well that is still covered

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fatfoo

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#10

07-12-2009, 05:02 PM

Hey, I got OHIP as well. Sucks about no advance notice. Don't see what it has to do with General Motors bailout.

Send me an email: [email protected]
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ottyhotties

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#11

07-12-2009, 05:10 PM

This thread doesn't read like an advertisement for government run health care I don't think.
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Iron Fist

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#12

07-12-2009, 05:11 PM

Originally posted by fatfoo

Hey, I got OHIP as well. Sucks about no advance notice. Don't see what it has to do with General Motors bailout.

I think he was implying that in order to pay for the bailout, they yanked coverage for seniors.

i like waffles
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SilentKnight

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#13

07-13-2009, 07:33 AM

Just to conclude this thread...

My father made a few calls to several gov't depts. this morning and managed to find someone who contradicted the pharmacist and said the meds "should be covered."

So he went back to the pharmacy to get the prescip - and was told again by the pharmacist that it wasn't covered. He had them call the person he'd spoken with and the record was set straight.

He only had to pay the dispensing fee for a 3-month supply.

Moral of the story - seems like if you raise enough stink they'll arbitrarily change policy. He's not sure at this point whether the pharmacy was ripping people off...or if the provincial gov't had done a reversal on their decision.
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tranza

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#14

07-13-2009, 09:16 AM

O thought it was OHIO... hahahahaa

I'm just a newbie.
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