Co Payment Application For Seniors Form PDF Details

The Co-Payment Application for Seniors is issued by the Ministry of Health and Long-Term Care. It provides qualifying Ontario seniors aged 65 and older access to the Ontario Drug Benefit (ODB) Program at a reduced $2 co-payment per prescription, rather than paying full out-of-pocket drug costs.

The reduced co-payment applies to individuals with an annual net income below $16,018. Couples or those with a common-law partner qualify when their combined net income is below $24,175. These income thresholds are set by the Ministry and may be updated annually.

Applicants must supply their personal information, income details, and a signed consent allowing the Ministry to verify income through Canada Revenue Agency (CRA) records. If you have a spouse or common-law partner, their information and signature are also required on the form. Both parties must confirm the accuracy of the data provided.

Once approved, the $2 co-payment applies to all medications listed on the Ontario Drug Benefit Formulary. This can produce significant annual savings for seniors managing multiple prescriptions. The Ministry uses CRA data solely to determine eligibility for this program.

QuestionAnswer
Form NameCo Payment Application For Seniors Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesodb co payment form, senior copayment program, odb copayment application, odb copay form for seniors