Costs and Financial Assistance

Costs related to diabetes treatment may include

  1. Medications
  2. Insulin
  3. Blood sugar monitoring strips
  4. Needle tips
  5. Lancets
  6. Foot care
  7. Eye care
  8. Dental care

What Coverage is Available?

A. Employment benefit plans or private health insurance plans

Each plan works differently. Most plans cover medications, insulin and blood sugar monitoring strips. Dental, eye and foot care will be variable. Contact your plan administrator for details.

B. Ontario Drug Benefits (ODB) for all people over age 65.

Click HERE to visit the Ministry of Health website to see if you are eligible.

On the first day of the month after you turn 65 years of age, take your prescription and health card to your pharmacy. Tell the pharmacist that you are now eligible for the ODB program. Under the ODB program, you pay a yearly set amount of up to $100 towards your drugs, called a deductible. Once you pay the yearly deductible, you will pay up to the maximum ODB dispensing fee of $6.11 for each prescription drug. This fee is called a “co-payment.

Depending on your income, you might be able to pay a lower payment per prescription through the Seniors Co-Payment Program.

Click HERE for the application form

ODB provides yearly grants for seniors on insuin to assist with costs of needle tips or syringes.

Click HERE information and application form.

C. Ontario Disability Support Program (ODSP)

ODSP will provide a drug card that will cover most medications, insulin and blood sugar monitoring strips. Extra money may be added to your monthly cheque to pay for needle tips, lancets, glucose sensors special diets and in some cases travel to appointments. Your worker can give you the Medical Necessities and Special Diet Allowance forms that we can assist you with. Your worker can also give you information about dental, eye and foot care.

Click HERE for more information on this program

D. Assistance for Children with Severe Disabilities (ACSD)

Children with Type 1 diabetes will medically qualify for this program. Call 519 376 1951 to ask if you qualify based on your family income.

ACSD can provide a drug card that will cover most medications, insulin and blood sugar monitoring strips. Extra money may be added to your monthly cheque to pay for needle tips, lancets, glucose sensors, special diets and in some cases travel to appointments. Your worker can give you the Medical Necessities and Special Diet Allowance forms that we can assist you with. Your worker can also give you information about dental, eye and foot care.

E. OW (Ontario Works)

OW may provide a drug card that will cover most medications, insulin and blood sugar monitoring strips. Ask your worker about other costs like: needle tips, lancets, special diets, dental, eye and foot care and travel to appointments.

F. Trillium Drug Benefits

Trillium Drug Program is funded through the Ministry of Health and Long Term Care and will provide a drug card that will cover most medications, insulin and blood sugar monitoring strips. Everyone can access this program but there is a deductible amount which must be paid every three months. The deductible amount is determined by household income and the number of people in the household so a cost/benefit analysis should be done to ensure that this program will be worthwhile financially.

Click HERE to access the Trillium Drug Program guide on the Ministry of Health Website

Click HERE for the Trillium Drug Program application

G. Non Insured Health Benefits (NIHB)

Health Canada provides eligible First Nations people and Inuit with a specified range of medically necessary health-related goods and services when they are not covered through private insurance plans or provincial/territorial health and social programs.
Non-Insured Health Benefits (NIHB) include prescription drugs, over-the-counter medication, medical supplies and equipment, mental health counselling, dental care, vision care, and medical transportation.

Click HERE to visit the Health Canada website to learn more about NIHB benefits.

H. Monitoring for Health

Monitoring for Health is an Ontario Ministry of Health and Long-Term Care funded program that is administered by the Canadian Diabetes Association. For those persons with no other options for coverage, this program will cover 75% of the cost blood glucose monitoring strips up to a maximum of $820.00/year for people who use insulin.

For more information and/or to receive an Ontario Monitoring for Health Program claim form, call 1-800-361-0796 or ask your Diabetes Educator.

Click HERE for more information on the Monitoring for Health program

I. Compassionate Insulin & Glucagon

Insulin companies offer compassionate insulin programs. Ask your Diabetes Educator for details.

Insulin Pump Coverage

Pumps

Insulin pumps are 100% paid for by the Assistive Devices Program (ADP) through the Ministry of Health and Long Term Care if you meet the eligibility criteria.

Click HERE to visit the Ministry of Health website for details on the ADP program funding for Inulin Pumps

Pump Supplies

The ADP program provides a grant of $2400.00/year for the purchase of insulin reservoirs, tubing and infusion sets or pods for the delivery of insulin. The annual estimated cost of supplies is $3000.00. You are responsible for paying about $600 a year. Consult individual pump companies for assistance in estimating costs. The insulin pump supply grant does not cover the cost blood glucose monitoring strips, insulin, continuous glucose transmitters or glucose sensors. The government program conducts random audits requiring receipts for insulin pump supplies only.

Employment benefit plans or private health insurance plans may cover expenses that exceed the $2400.00 grant. Consult your plan administrator for details.

If you receive benefits from Ontario Works, Ontario Disability Support Program or Assistance for Children with Severe Disabilities, you may be eligible for additional money to cover the expenses that exceed the $2,400.00 grant. Consult your worker about these costs.

Continuous Glucose Transmitters & Sensors

Employment plans or private health insurance plans may cover these expenses. The Insulin Pump companies will assist you in seeking this coverage if you are interested.

Ontario Disability Support Program or the Assistance for Children with Severe Disabilities may provide some support for sensors only.