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10 Oct 2017

PrEP in Ontario – Update for Community

AIDS Committee of Toronto (ACT), September 28, 2017

Contact: Amanda Leo aleo@whai.ca 416-340-8484 ext. 221 Alex Urquhart aurquhart@actoronto.org 416-340-8484 ext. 234

On September 28, 2017, PrEP became more accessible to people living in Ontario than ever before. PrEP is a highly effective way to prevent HIV that involves taking a pill every day and going for regular checkups with a doctor. ACT has long advocated for increased access to PrEP, and welcomed this news. But drug coverage in Ontario is confusing, so here’s a brief rundown of how this news affects you. 

What Changed:

PrEP used to cost $1,000 a month, but now it can be either free or as low as $50 per month, depending on what kind of drug insurance you have. Anyone who is registered with ODSP, Ontario Works or Ontario’s Senior drug plan can now have PrEP covered for free. Anyone else seeking assistance paying for PrEP can register with the province’s Trillium drug plan for coverage. A prescription from an HIV specialist is no longer required to receive coverage. You can get a script from any doctor or nurse practitioner and be covered under Ontario’s plans.

If you have private drug insurance (most likely through your employer), the change won’t make much of a difference. But if your private plan was one that didn’t previously cover PrEP, they are more likely to do so now. Check with them about your coverage options.

People who won’t have to pay anything for PrEP:

• those who have federal health insurance. This includes indigenous people (with status), members of the armed forces, and refugees.

• if you are under 25, starting January 1st 2018, PrEP will be free through the new OHIP+ program

• if you are 65 or over, are on ODSB, or Ontario Works, PrEP is covered through the Ontario Drug Benefit

People who will pay a deductible for PrEP:

• if you don’t have private drug insurance or federal drug insurance and are between the ages of 25 and 64, you can get PrEP through Trillium. This will require you to apply to the program and pay a deductible based on your income. You can apply for Trillium even if you have private insurance if your coverage isn’t 100%.

• if your private insurance plan pays only a certain percentage of your prescription (such as 50% or 80%), you will have to pay the rest. If PrEP costs $200 per month, and your insurance pays 75%, you pay $50 per month.

To get started with accessing PrEP, visit a healthcare provider you are comfortable returning to, as taking PrEP requires you to return for regular checkups (every three months). If you have one, your family doctor is best, although sexual health and community clinics can provide you a prescription to begin PrEP. As can walk-in clinics, though returning to them for check-ups can be tricky. 

Read more about:

Taking PrEP to prevent HIV as Gay, Bi or Queer Guy 

Taking PrEP as a Woman

Trillium Drug Plan Deductible Calculator

Finding a Family Doctor

 

ACT – AIDS Committee of Toronto 543 Yonge Street, 4th floor, Toronto ON. M4Y 1Y5

T 416-340-2437 F 416-340-8224 W actoronto.org

BN 11877 9024 RR0001 

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