Exceptional Access Program & OHIP+: What do I do?

Text with the word analyzing circled in red.With the recent implementation of OHIP+ there have been specific situations where a drug is not currently on the ODP listing; however it is listed on the drug Exceptional Access Program.  In these situations the insurance company does not cover the drug because the medication could possibly be covered under the OHIP+ plan.

When this happens the patient needs to complete an application to have the drug approved under Exceptional Access Program.  Once the application is approved then OHIP+ becomes 1st payor, and the insurance  company becomes 2nd.

If the drug is not approved, then the individual must furnish a copy of the decline letter to the insurance company so they knows the drug is not being covered.  This allows the insurance company to now become 1st payor.

We have attached a link to the actual application for Exceptional Access Program for your convenience.

Request for Unlisted Drug Product