Blood Glucose strip supported by Ontario Drug Benefit (ODB)

Who is eligible?

Eligibility for the Ontario Drug Benefit (ODB) program's support for blood glucose test strips is primarily based on the following criteria:

1. Age: Individuals who are 65 years of age or older.
2. Residency: Residents of Ontario with a valid Ontario health card.
3. Financial Assistance Programs: Individuals receiving benefits from specific Ontario government programs such as:
   • Ontario Works (OW)
   • Ontario Disability Support Program (ODSP)
   • Trillium Drug Program (TDP)
4. Residents in Long-Term Care Homes or Homes for Special Care: Individuals residing in these facilities are covered.
5. Registered with the Home Care program: Individuals receiving home care services are also eligible.

For blood glucose test strips specifically, there might be additional considerations related to the medical necessity and the quantity of strips covered, which can be influenced by the individual's medical condition, such as diabetes type and the need for insulin. The ODB program periodically reviews and updates the criteria for coverage of diabetes testing supplies, including blood glucose test strips, to align with current medical guidelines and practices.

 

How many blood glucose strip are supported by ODB?

The number of blood glucose test strips that the Ontario Drug Benefit (ODB) program supports for eligible individuals depends on the patient's diabetes treatment regime. As of my last update, the coverage is generally structured as follows, but it's important to note that these guidelines might be updated or adjusted over time:

1. Individuals managing diabetes with insulin: Up to 3,000 test strips per year.
2. Individuals managing diabetes with anti-diabetes medication that has a high risk of causing hypoglycemia: Up to 400 test strips per year.
3. Individuals managing diabetes with anti-diabetes medication that has a low risk of causing hypoglycemia: Up to 200 test strips per year.
4. Individuals managing diabetes with diet and lifestyle alone (no diabetes medication): Up to 200 test strips per year.

The specific amount of test strips covered can also be influenced by the individual's medical needs and circumstances. Healthcare providers can apply for additional coverage based on medical necessity, ensuring patients receive the necessary supplies for their diabetes management.

https://www.ontario.ca/page/get-coverage-prescription-drugs#diabetes