If you have reached your annual or lifetime maximum for your private insurance plan and you are enrolled in the Trillium Drug Program (Trillium), any pharmacy in Ontario may be able to bill Trillium for your prescription medications.

You must complete the following steps for any pharmacy in Ontario to be able to bill Trillium directly:

1. Get a letter from your insurance company

Contact customer service at your insurance company and ask for a letter stating you have reached your insurance plan maximum coverage.

The letter must include:

1. The date you reached the coverage maximum
2. If the maximum is for the year (annual) or lifetime
3. The date when your insurance will cover your prescriptions again (reinstatement date)

Ask the customer service agent:

• If they can send you the letter by email in a PDF format. It will make it faster for you to get prescription drug coverage through Trillium.
• How long it will take to receive the letter. Call customer service if you have not received the letter by then.

Check the letter carefully to make sure there are no errors. If you find any errors, call customer service and ask them to send you an updated letter. Any errors will cause delays.

2. Send the letter to Trillium

Write your Trillium file number (starts with RA) or Ontario Health Card (OHIP) number on the letter and send it to Trillium. You can send it by:

• Email: Trillium@OntarioDrugBenefit.ca
• Fax: 416 642 3034
• Mail: Trillium Drug Program
  PO Box 337, Station D
  Etobicoke, ON M9A 4X3

3. Confirm Trillium received the letter

Contact Trillium within 5 business days of sending the letter.

• Confirm they received the letter and your request is being processed.
• Ask when your Trillium coverage will start.
• Trillium can be contacted at the following number: 1 800 575 5386

Can I get reimbursed (paid back) for prescriptions I paid for while waiting for Trillium coverage?

Trillium may reimburse you if your prescription costs are more than your Trillium deductible. (Your deductible is the amount of money you have to pay before Trillium will start to cover the cost of your prescriptions).

Mail your original prescription receipts to Trillium.

• Write your Trillium file number (RA number) on each receipt in case your documents get separated.
• Include a cover letter to Trillium stating you are asking to be reimbursed for prescriptions you paid for because your private insurance has reached maximum coverage.

For more information

Call your Pharmacy Team for more information about your prescription medications and the Trillium Drug Program.

This document was created in collaboration with UHN Outpatient Pharmacies and a transplant patient partner.