Regulation - LGIC

Updating of the Income Eligibility Thresholds for the Seniors Co-payment Program

Regulation Number(s):
O. Reg. 201/96
Instrument Type:
Regulation - LGIC
Bill or Act:
Summary of Decision:
Made: April 15, 2021
Filed: May 11, 2021
Published on e-Laws: May 11, 2021
Printed in The Ontario Gazette: May 29, 2021
Analysis of Regulatory Impact:
There would be anticipated incremental direct compliance costs to business as a result of the proposed regulatory amendments. These amendments are related to ensuring access to an existing program for eligible seniors.

Impact to Business
The proposal would not impose any administrative costs on business, including pharmacies. If the proposed is approved, pharmacies would be expected to help communicate the threshold changes to seniors as they normally would as part of their regular business.

Impact on Ontarians
The proposed changes would ensure that seniors receiving government income supports are eligible for the SCP. It is estimated that low-income seniors enrolled in the SCP save an average of about $105-$120 per year on prescription drugs compared to seniors who are not.

Other Costs
The proposed changes would result in implementation and financial costs to government related to I&IT changes, updates to program materials and anticipated higher program uptake. However, the proposed changes, if approved, would support the government's commitment to provide benefits to those who need them the most.
Further Information:
Proposal Number:
Posting Date:
March 26, 2021
Summary of Proposal:
The Ministry is proposing amendments to Ontario Regulation 201/96 (the Regulation) under the Ontario Drug Benefit Act (ODBA) that, if approved, would increase the income eligibility thresholds for the Seniors Co-Payment Program (SCP) to $22,200 for single seniors and $37,100 for senior couples, starting August 1, 2021, in order to ensure that the income eligibility thresholds continue to reflect cost-of-living increases in Ontario and are higher than increases to income supports for seniors.

By updating the eligibility thresholds, the Ministry is ensuring access to lower co-payments and deductibles for seniors who qualify for the SCP under the Ontario Drug Benefit (ODB) program.

This proposal is in support of people and families in Ontario and in line with the government commitment to provide benefits to those who need them the most.

The current income eligibility thresholds for SCP are $19,300 for single seniors and $32,300 for senior couples were last updated in 2016. The current thresholds are below the government income supports that some seniors receive, thus impacting SCP eligibility for certain seniors.

This proposal, if approved, would update the eligibility thresholds to $22,200 for single seniors and $37,100 for senior couples, starting August 1, 2021
Contact Address:
Ministry of Health
Drugs and Devices Division
5700 Yonge St., 3rd Floor
Toronto ON M2M 4K5
Effective Date:
August 1, 2021