On the Radar from CLEO
CLEO On The Radar
September 2022
This version of On the Radar replaces the one sent on September 8, 2022.
Helping seniors with health costs
As people get older, they often need to find different ways to cover their health costs. There are some government benefits that can help them do this.
When a person turns 65, there's a risk that they'll no longer qualify financially for the Ontario Disability Support Program (ODSP), including ODSP health benefits. These health benefits cover things like prescription drugs, routine eye examinations, and dental care.
They may no longer qualify for ODSP because at 65 they automatically get the Old Age Security (OAS) pension and might also be eligible for the Guaranteed Income Supplement (GIS) and the Guaranteed Annual Income System (GAINS).
Getting these income supports likely means that their income will be too high to qualify for ODSP.
ODSP's Extended Health Benefit
The Extended Health Benefit (EHB) is for people who:
  • are no longer eligible for ODSP because their income is too high, and
  • have high health costs.
The EHB can help with the cost of:
  • prescription drugs and medical supplies
  • dental and vision care
  • travelling to medical appointments
  • assistive devices, such as hearing aids
To qualify, the person must still be eligible for ODSP except for the fact that their income is too high. For example, they must be a resident of Ontario and have no more assets than what ODSP allows.
As well, to qualify for the EHB, their health costs must be higher than the difference between:
  • their current income, and
  • the amount of ODSP income support that they had been getting each month.
For example, a person might have been getting $1,228 from ODSP each month and now they get $1,644 with OAS and other income supports. This means they have $416 more in income each month. If their health expenses are more than $416, they can apply for the EHB.
They apply through their local ODSP office. And they need proof of their health costs, such as a list of prescription drug costs from their pharmacy.
CPP disability benefits and retirement pension
Up until age 65, people who pay into the Canada Pension Plan (CPP) and have a long-term disability can apply for CPP disability benefits.
CPP disability benefits are fixed monthly payments. The amount a person gets depends on how much they contributed to the CPP, not on the cost of their medical expenses.
Once someone turns 65, their CPP disability benefits automatically turn into a CPP retirement pension.
The CPP retirement pension pays less than CPP disability benefits. This leaves some seniors without enough money to cover their health costs.
Seniors Co-Payment Program
All Ontario residents who are 65 and older, automatically qualify for the Ontario Drug Benefit (ODB) program. The ODB covers a certain amount of prescription costs depending on the person's income. And they must pay a deductible each year, which is the first $100 of their yearly prescription costs.
People may also be able to apply to the Seniors Co-Payment Program. This program is for:
  • single people over 65 who have an income of less than $22,200, and
  • couples with at least one spouse over 65 and a combined income of $37,100 or less.
There's no annual deductible and people only pay up to $2 for each prescription.
New tax credit for people over 70
In 2022, the Government of Ontario created the Ontario Seniors Care at Home Tax Credit, a new refundable tax credit for residents who:
  • are over 70, and
  • earn less than $65,000 a year.
The tax credit lets people claim a refund of up to 25% of their eligible medical expenses up to $6,000. The maximum credit is $1,500.
Eligible medical expenses are the same as those claimed through the existing Ontario Medical Expense Tax Credit, and include:
  • attendant care
  • assistive breathing devices
  • dental, vision, and hearing care
  • wheelchairs and electric scooters
  • hospital beds and bathroom aids
To get the credit, the person must claim their eligible medical expenses on their income tax return. People can claim this new credit as well as the existing Ontario Medical Expense Tax Credit.
Where to get help
Seniors who have a low income can get help with pensions and income assistance from their local community legal clinic.
They can also contact the Advocacy Centre for the Elderly, which specializes in providing legal services to seniors.
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