Health Benefits After You Leave the Ontario Disability Support Program

If you leave Ontario Disability Support Program (ODSP) Income Support, you may be able to get help to cover some of your health care costs.

There are two types of health benefits available:

• Extended Health Benefits – for people who leave the ODSP and have high health costs
• Transitional Health Benefit – for people who leave the ODSP for paid work, and who are not eligible for Extended Health Benefits or health benefits from their employer.

Extended Health Benefits

If you are no longer eligible for ODSP Income Support because your income, from any source, is too high and you have high health costs, you may be eligible for Extended Health Benefits.

Depending on your needs, Extended Health Benefits can cover:

• Prescription drugs
• Dental 
• Eyeglasses and hearing aids
• Diabetic supplies
• Surgical supplies and dressings
• Transportation to and from necessary medical appointments
• The consumer contribution for an assistive device, such as a wheelchair or prosthetic, that is funded by the Ministry of Health and Long Term Care’s Assistive Devices Program. (For more information on this program, visit www.health.gov.on.ca.)

To be eligible for Extended Health Benefits, your health costs must be more than the amount of your excess income. Excess income is the difference between your current net income (e.g., from your pension, employment earnings or training allowance) and the amount of ODSP Income Support you would be receiving if you were still on the ODSP.

Example: Single ODSP Recipient

In this example, the Single ODSP Recipient is eligible for Extended Health Benefits because her health costs ($135/month) are higher than her excess income ($104/month).

If you do not qualify for Extended Health Benefits, you may still be eligible for the Transitional Health Benefit if you leave ODSP Income Support for paid work.

Transitional Health Benefit

The Transitional Health Benefit covers prescription drugs, dental services and vision care.

You may be eligible for the Transitional Health Benefit if you leave ODSP Income Support for paid work (full-time or part-time job, training program, or self-employment) and if you do not have employer health coverage. You will continue to receive the Transitional Health Benefit from the ODSP until health benefits are provided by your employer. The ODSP will review your eligibility annually.

You do not need to have high health costs to be eligible for the Transitional Health Benefit. You may be eligible for this benefit regardless of your income or assets.

How to Apply

If you are leaving ODSP Income Support, contact your worker through your local ODSP office.

Your ODSP worker will first determine if you are eligible for Extended Health Benefits. You will need to provide proof of your health costs, such as a list of your prescription drug costs from your pharmacy and receipts for other health costs for the previous 12-month period.

If you do not qualify for Extended Health Benefits, your ODSP worker will then determine whether or not you are eligible for the Transitional Health Benefit.

Other Help

If you do not qualify for either health benefit, you can apply to the Ministry of Health and Long-Term Care’s Trillium Drug Program for help with your prescription drug costs. Applications are available at pharmacies or by calling the Trillium Drug Program at 1-800-575-5386.

Need More Information?

For more information, please contact your worker through your local ODSP office.

For general inquiries, please contact:
Ministry of Community and Social Services
Telephone: 1-888-789-4199
Teletypewriter (TTY): 1-800-387-5559
www.mcss.gov.on.ca

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