This information applies to Foria patients in Ontario.
Ontario Drug Benefit (ODB) program
If you live in Ontario, some forms of hormone therapy are covered by the Ontario Drug Benefit (ODB) program. These are topical and injectable testosterone, oral estrogen and anti-androgens. Topical and injectable estrogen are not covered.
ODB includes Ontario Works (OW), the Ontario Disability Support Program (ODSP), people over 65 years of age, people under 24 years of age without private insurance (via OHIP+) and those on the Trillium Drug Program. Your co-pay (the amount you pay after your insurance coverage) will vary depending on factors like your income and the sub-program you are enrolled on.
Getting your medication covered is a different process depending on which medicines you take. Estradiol and anti-androgens are automatically covered and need no extra paperwork. Injectable and topical testosterone are covered with the submission of a form to the Exceptional Access Program (EAP). Foria clinicians can submit this form for you and send the approval to your preferred pharmacy when it has been processed.
Hormone therapy is also covered by some private insurance programs but this can vary. If you have private insurance, speak to your provider about coverage.
Out of pocket
If you’re paying out of pocket in Ontario, this is roughly how much you can expect to pay for medications. These are based on average doses and don’t include pharmacy fees. You should contact your pharmacy directly to inquire about exact costs to you.