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Income Security Advocacy Centre

Income Security Advocacy Centre

ISAC works to address issues of income security and poverty in Ontario

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Drug Benefits for Social Assistance Recipients: S.S. v. Ontario Public Drug Programs

January 11, 2019

The Ontario Drug Benefit is an essential program that ensures that social assistance recipients and seniors can access the medications they need. However, the Ontario Drug Benefit does not cover the costs of all medications.

ISAC co-counselled with Mississauga Community Legal Services on a case about a medication that the Ontario Drug Benefit refused to cover. This case addressed the importance of ensuring access to essential medications for social assistance recipients.

S.S. has a number of medical conditions, including chronic nerve-related pain. Because of her complicated health situation, none of the treatments that are covered by the Ontario Drug Benefit are suitable or effective for her. A cream that safely treats her pain is available, but it is not on the list of medications covered by the program.

The Ontario Drug Benefit plan has a process for applying for “exceptional access” in cases like this. S.S.’s doctor applied for exceptional access, but the program rejected the application. S.S. was not given any explanation for the rejection, just that the cream is not “eligible.”

ISAC and Mississauga Community Legal Services  started an “application for judicial review” to challenge that decision. To read that application, click here.

The application did not go to a hearing.

-January 2019

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This site contains general legal information for people in Ontario, Canada. It is not intended to be used as legal advice for a specific legal problem. ISAC is a not-for-profit, non-partisan organization. ISAC is funded by Legal Aid Ontario (LAO). The funding for this website is also provided by LAO. The views expressed in any of ISAC’s publications (including written, oral, or visual) are the views of the clinic and do not necessarily reflect those of LAO.