View Full Version : Medical Insurance

04-05-2009, 08:51 PM
I was just wondering, if someone doesn't have any type of benefits through their work is their companies that provide medical insurance for like a monthly cost? Like car insurance....
I am on many medications and without benefits they can be quite costly

04-05-2009, 08:52 PM
yes there is
if you dont get info on here u can ask your pharmacist, they would know
yrs ago there used to be trillium, but i don't know if that's still around

Chaotic Chick
04-05-2009, 08:54 PM
Yes, Trillium is still around. My friend has Trillium and he said it is worth it if you are on several medications and spend a lot of money every month.

04-05-2009, 09:00 PM
you can also inquire through your house or car insurance company for a list of places or look on-line for medical insurance companies and their policies.

04-06-2009, 07:18 AM
Where do I get contact info for Trillium?

Chaotic Chick
04-06-2009, 07:57 AM
At the pharmacy.

04-06-2009, 08:19 AM
Go here and download the booklet that goes with the application. Anyone applying for Trillium should read the booklet (all 25 pages) in order to understand how the program works and whether it will be beneficial for them, as it's not for everyone.


The application form for Trillium can be found here


As the description states, "the Trillium Drug Program (TDP) is an annual provincial government program for residents of Ontario who have a valid Ontario health card and spend a large part of their income on prescription medications..."

"Large part" are key words which should be noted. There is a deductible which you will have to pay which is roughly 4% of your net income from the previous year. You will be asked to submit your income tax notice of assessment for the previous year and each year that you are on the program. The deductible is paid through your purchase of non-refundable / non-covered drug expenses, meaning you go to your drug store and buy your drugs, but the assessed deductible must be spent first and then any costs over and above the deductible amount are eligible for reimbursement. You do not receive any reimbursement of the deductible amount.

For example, someone making $40,000 a year and clearing $32,000 after taxes would still have to have an average cost of $1,600 per year for drugs before Trillium would begin paying back any money and then it would only be on anything over the $1,600.

If that same person has drug coverage for say, 80% though work, they can still use Trillium on top of their work coverage, but the same $1,600 would still apply and in this case, it would apply only to the amount paid over and above what their private insurance covers. So, in this case, the the person would need to have drug expenses exceeding $8,000 per year before he or she would get any reimbursement from Trillium ($6,400 being covered by their private insurer).

It should also be noted that your deductible amount is based on net HOUSEHOLD income and not individual, so if you have a spouse or common-law that is also earning income, the deductible will be based on a combination of the 2 incomes which can also significantly increase the deductible amount.

Trillium is a great program and beneficial for those who can use it, but it's not a program for someone needing occassional prescriptions or inexpensive prescriptions for cold or flu meds.

There are also some meds which are either new to the market or still considered to be in clinical stages (which can be years after they were introduced) or are simply too expensive for Trillium to cover with no questions asked. These drugs may sometimes be secured through Trillium if your doctor is able (and willing) to complete a Section 8 which requires that they complete a detailed history of you as a patient plus their rationale for believing that you would respond to one of these drugs. Of course, there's no guarantee that Trillium approves the drug even if the doctor does this.

04-06-2009, 12:14 PM
So I i make less the 15,000 a year and live on my own (Im a student and work part time) even when i work full time im still under 25, 000 and my prescriptions for say just one of the meds is 85$ for 3months ( this is just one of the meds) would it be worth it?

04-06-2009, 12:35 PM
If someone was making 20,000 a year then the deductible would be 800 dollars. If you are spending significantly more than 800 dollars a year on meds, then it would be worth it.

04-06-2009, 12:51 PM
If you are a full time student in either College or University, you might want to check your student handbook or stop in at the councelling office. It's been about a decade since I was in college, but at that time full time students had a drug plan through the college.

The chart listing deductibles in the Trillium guide shows that a single person living on their own making $15,000 to $15,500 net income would have a deductible of $449 annually. This would be divided up into quarterly payments of $112 every 3 months (payments in this case being the amount that you pay to the pharmacy for your drugs, not to the government as the word deductible might imply - the pharmacist puts it into the computer for you and it is tracked that way). With just that single drug at $85 for 3 months, you would not qualify to get anything back. If for example you had a second drug that cost $50 every three months and brought your total up to $135 every 3 months, you would get $23 back. It's not much, but again, the program was designed more for individuals that require assistance paying for drugs that would otherwise bankrupt them.

That said however, there is no cost to register for the Trillium program and if you do not hit the threshold where you get money back, it is still no extra money out of your pocket, you just keep paying for your prescriptions the same as you are now.

04-06-2009, 04:45 PM
Most college/University students should be covered under the school's drug plan if they are full time students.

04-06-2009, 06:55 PM
Yes, Trillium is still around. My friend has Trillium and he said it is worth it if you are on several medications and spend a lot of money every month.

Depends on what kinds of drugs you use. For me Trillium covered practically nothing and did next to nothing to save me money, I spend like $300 or $400 on drugs in a given month with my asthma and diabetes and stuff and to continue using the recent and better insulin and other meds they where mostly not covered by Trillium. So let your pharmacist know you plan on trying this, they have a list of mes that are and are not covered. if the pharmacist says they are a schedule 8 or something, assume it will not be covered :/ they claim you have to get your doctor to write a letter specifying why this medication is important etc... my specialist wrote this letter and they just never said anything and did not cover it.