The Trillium Drug Program (TDP) is an Ontario Ministry of Health program for people whose prescription drug costs are high compared with their household income. Your household first pays a yearly deductible, usually about 4% of its after-tax income, and after that you pay up to $2 for each prescription filled or refilled. The deductible is split into four parts, one for each quarter of the program year, which runs August 1 to July 31. You apply as a household, and enrolment renews each year when your household files its taxes on time.
Looking for the Ontario Trillium Benefit, the tax credit paid by the Canada Revenue Agency? That is a different program, explained on our Ontario Trillium Benefit page.
On this page: Who qualifies · The deductible · How to apply · Renewing · OHIP+, ODB and private plans · National pharmacare · Other provinces
What is the Trillium Drug Program?
The TDP pays for the more than 5,900 medications on the Ontario Drug Benefit program’s list, and for almost 1,500 more drug products that meet set criteria through the Exceptional Access Program. It isn’t a tax credit: you apply to the program directly.
Who qualifies?
Ontario’s program page says to apply if you:
- you live in Ontario, with a valid health card number
- you aren’t already covered by the Ontario Drug Benefit program (people on Ontario Works, for example, are)
- don’t have an insurance plan that pays for 100% of your drugs
- spend about 4% or more of your household’s after-tax income on prescription drugs
The Ministry’s guide adds an age range: 25 to 64, or 24 and under with a private plan. Younger people without a private plan are covered through OHIP+ instead.
Who counts as your household?
You apply as a household, and you can apply on your own if you live alone or only with people outside these groups:
- A spouse: someone you’re married to, or a partner you live with in a conjugal relationship who has lived with you for at least 1 year, is the other parent of your child, or has a cohabitation agreement with you under section 53 of Ontario’s Family Law Act.
- A dependent relative: someone you live with where one of you is the other’s parent, grandparent or legal guardian and one depends on the other for support, including someone under 25 who is eligible for OHIP+.
A family member other than your spouse who is financially independent is left off your application and can apply on their own: that means self-supporting, paying market-value rent and their own living costs, and neither relying on nor supporting other family members in the home.
How is the deductible worked out?
The deductible is what your household pays out of pocket for its first eligible drugs before coverage starts. It’s based on household income: each member’s net income for the previous tax year, from line 23600 of the notice of assessment, minus any RDSP withdrawals reported on line 12500.
The result is roughly 4% of household income. The exact amount comes from the Ministry’s guide: a table by income range and household size for incomes under $100,000, and a formula above that. Your confirmation letter states your figure.
The program splits the yearly deductible into 4 equal parts, one per quarter:
- August, September, October
- November, December, January
- February, March, April
- May, June, July
At the start of each quarter you pay for prescriptions yourself until that quarter’s part is paid, then up to $2 a prescription until the quarter ends. If you don’t spend enough to cover a quarter’s part, the rest moves to the next quarter, but not past the fourth quarter into the next year. Only what your household paid itself counts: the share paid by a private insurer, a drug company or a discount card doesn’t.
Example. A household of two had $60,000 of combined net income last year. At 4%, that suggests a deductible of about $2,400 a year, or $600 a quarter. The guide’s table for a household of two with $59,501 to $60,000 gives $2,189 a year, so each quarter’s part is $547.25.
From August to October the household buys $400 of covered drugs, so the unpaid $147.25 moves to the November-to-January quarter, whose part becomes $694.50. Once that is paid, each prescription costs up to $2 until the quarter ends.
Above $100,000, the guide’s formula takes household net income, subtracts $20,000, multiplies by 0.045, adds $500, then subtracts $0 to $200 depending on household size.
What if your income drops?
If household income changes by 10% or more, you can ask the program to recalculate the deductible with its Annual Deductible Re-Assessment Request form. The new amount starts from the beginning of the quarter in which it’s recalculated, and earlier quarters stay as they were.
How do you apply?
- Get the application. The Trillium Drug Program Application is on the Ontario Drug Benefit online forms site. Without a computer, you can ask for a paper form and the guide by phone at 1-800-575-5386 (416-642-3038 in Toronto) or by email at [email protected].
- List everyone in your household and report any insurance that pays for drugs for any of them, including a health spending account.
- Sign and give the CRA consent. Everyone 18 or older signs the form and agrees to let the Canada Revenue Agency share their income information, and the program needs their Social Insurance Number even if they don’t file a tax return. It checks income for members 19 and older.
- Choose your enrolment start date. Prescriptions filled before it don’t count toward the deductible and aren’t paid back, and a later start lowers the first year’s deductible for the days left in the year. Picking the day you filled your first eligible prescription that year can save money, the guide says. If you leave it blank, your application waits until you give a date, and once your enrolment is confirmed the date can’t be changed.
To be paid back for drugs from the program year that just ended, apply by September 30. The guide says delays usually come from an incomplete application, for example a missing signature or health number, late tax returns, or missing details about private insurance.
What receipts to keep, and how to claim them
Keep the official prescription receipt from the pharmacy, signed by a pharmacist; cash register slips, card receipts and clinic invoices aren’t accepted. If you lose one, the pharmacist can give you a Patient Medical Expense Report instead. Send receipts through the online receipt form, or by mail with your TDP file number or health card number. Out-of-pocket costs for eligible drugs count toward your deductible, and amounts above a quarter’s part are paid back by cheque. Receipts for a program year must reach the program by October 31.
Do you have to reapply each year?
No: your household’s enrolment renews automatically every year if you file your taxes on time, and you get a confirmation letter each year. The guide lists when it won’t renew:
- a household member 19 or older didn’t file a tax return for the previous year
- a member turning 18 before August 1 hasn’t signed the CRA consent
- the household paid nothing toward its deductible in the previous 2 program years
- every member is now 65 or older
A household that loses coverage reapplies with a new form.
How does it fit with OHIP+, the Ontario Drug Benefit and private plans?
OHIP+. People 24 and under with OHIP coverage and no private plan get covered drugs at no charge through OHIP+. Having a private plan rules out OHIP+, but a household with a plan and large out-of-pocket costs can apply to the TDP.
The Ontario Drug Benefit. You may qualify for the Ontario Drug Benefit program when you turn 65. Seniors there pay the first $100 of prescription costs each program year, then up to $6.11 a prescription, or no deductible and up to $2 in the Seniors Co-Payment Program. People receiving Ontario Works or ODSP can qualify for the Ontario Drug Benefit instead.
Private plans. The TDP isn’t meant to replace a plan from work or school or a private plan. Claims go to your insurer first, and the costs it leaves you to pay count toward your deductible when you send in the receipts. If your household pays premiums for that plan, the program gives a credit against the deductible of up to $100 for one person or $200 for two or more, with a letter from the insurer each year.
What is national pharmacare?
National pharmacare is a federal program that makes a range of contraception and diabetes medications free at the pharmacy in provinces and territories that have signed a funding agreement with Ottawa. 4 have signed: British Columbia, Manitoba, Prince Edward Island and Yukon. Ontario isn’t among them; for a province without an agreement, Health Canada points people to their own health ministry for drug coverage.
Health Canada’s examples include oral contraceptives, IUDs, rings, implants and injections, and metformin, insulin, sulfonylureas and SGLT-2 inhibitors; each agreement has its own list. Pharmacare pays for listed products, dispensing fee included, but not delivery fees or pharmacist prescribing fees, and you don’t have to go through a private plan for them.
Do other provinces have a program like Trillium?
Several provinces run their own drug programs that help when costs are high or coverage is missing. A few of them:
| Province | Program | Who it helps |
|---|---|---|
| British Columbia | Fair PharmaCare | British Columbia families get help based on income: the less they earn, the more help |
| Saskatchewan | Special Support Program | Income-tested help with drug costs, for Saskatchewan residents who sign up |
| Manitoba | Manitoba Pharmacare Program | Manitobans of any age whose income is hit hard by drug costs |
| New Brunswick | New Brunswick Drug Plan | New Brunswickers with no drug insurance, or with insurance that leaves out some prescriptions |
| Nova Scotia | Family Pharmacare Program | Nova Scotians with no drug coverage, or whose drug costs have become a burden |
| Newfoundland and Labrador | Newfoundland and Labrador Prescription Drug Program (Access Plan and Assurance Plan) | The Access Plan covers people and families with low incomes in Newfoundland and Labrador |
Contact and related pages
The TDP answers at 1-800-575-5386 or 416-642-3038 in Toronto (TTY 1-800-387-5559), Monday to Friday, 9am to 5pm (excluding holidays).
Sources
The figures and rules on this page come from these sources, last checked against them on October 13, 2026. How we check facts.
- forms.mgcs.gov.on.ca: Ministry of Health: A Guide to Understanding the Trillium Drug Program
- Government of British Columbia: Fair PharmaCare plan
- Government of Canada: About national pharmacare
- Government of Canada: What’s covered by national pharmacare
- Government of Canada: National pharmacare bilateral agreements
- Government of Manitoba: Pharmacare Program | Health
- Government of New Brunswick: Enrol in the New Brunswick Drug Plan - gnb.ca
- Government of Newfoundland and Labrador: Plan Overview - Health and Community Services
- Government of Nova Scotia: Register for the Family Pharmacare Program
- Government of Ontario: Get help with high prescription drug costs
- Government of Ontario: Get coverage for prescription drugs
- Government of Ontario: Learn about OHIP+
- Government of Saskatchewan: Drug Cost Assistance | Extended Benefits and Drug Plan