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Co-Payment Application for Seniors - Ontario

3233-87E (2016/07) Queen's Printer for Ontario , 2016 Disponible en fran aisMinistry of Health and Long-Term Care Co-Payment Application for Seniors GuideGeneral InformationOnce you turn 65, you automatically qualify to have your eligible prescription drug costs covered through the Ontario Drug Benefit (ODB) program. Your ODB coverage starts on the first day of the month after your 65th birthday, if you live in Ontario and have a valid Health Card. Under the ODB program, you pay a yearly set amount of up to $100 towards your drugs, called a deductible. You pay off your deductible by buying prescription drugs covered under the ODB. Once you pay the yearly deductible, you will pay up to the maximum ODB dispensing fee of $ for each prescription drug. This fee is called a Co-Payment .

Ministry of Health and Long-Term Care Co-Payment Application for Seniors Notice of Collection of Personal Information This information is collected under the authority of the

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