Health Support

Help with Health-Related Expenses for Low-Income Residents

Hardship Fund

The Hardship Fund is available to pay for certain medically based items/services such as eyeglasses, emergency dental work, medication, medical items (walkers, hearing aids, hospital beds and more) or funeral expenses. Low-income Toronto residents who are not receiving assistance from Ontario Works or the Ontario Disability Support Program (ODSP) may receive help from Toronto’s Hardship Fund regardless of their immigration status in Canada.

If you are not receiving assistance, you must apply for Toronto’s Hardship Fund to see if you qualify. It is important that you apply before paying for your medical items/services, as you may not be reimbursed for some items/services if you have already paid for them.

Who Can Apply

Low-income Toronto residents, who are not receiving assistance from Ontario Works or ODSP, who require help with a medically based item/service, may apply through Toronto’s Hardship Fund.

How to Apply

To apply for the Hardship Fund, call 416-338-8888. You will need to provide information about your financial situation and have details and a cost estimate for the medically based item/service you need.  It is important that you apply before paying for your medical items/services, as you may not be reimbursed for some items/services if you have already paid for them.

For more details about what information is required to apply for specific items through the Hardship Fund, read about eyeglasses, dental services, medication, medical supplies and devices or funeral expenses.

If it seems that you qualify, you will need to come to an appointment to finish the application. Usually this appointment takes place at your local Employment and Social Services office (generally closest to where you live in Toronto). If you are not able to physically come to the office, other arrangements can be made.

If you do not speak English or French you will need an interpreter when you call to apply. For help finding an interpreter, visit 211Toronto.

After Applying

Your eligibility for Toronto’s Hardship Fund will depend on the cost of the medically-based item/service you need, whether or not that item/service can be covered by the Fund, and your financial situation

Low-income residents who apply for the Hardship Fund will be told by the caseworker whether or not they qualify after all needed documents have been provided.

 

Dental – Ontario Works and ODSP

Dental and Dentures for Adults – Ontario Works

Through Ontario Works, adults (18 years and older) are eligible for emergency dental treatments. If you have a serious dental problem, visit a dentist or one of the Toronto Public Health Dental Clinics for treatment.

You need to let the dentist know that you are receiving Ontario Works assistance and bring your Health card and Statement of Assistance to your dentist appointment so that you are not charged for covered services. Employment and Social Services does not reimburse dental costs.

You may also get help with other services such as:

• dentures
• replacements, repairs and relines
• lab fees and exams

You must let your dentist or denturist know that you are receiving Ontario Works, as they must get pre-approval for the denture services you need. Denture costs can not be reimbursed.

If you are on Ontario Works, have been denied dental or denture services, and would like to appeal the decision, contact Employment and Social Services’ Appeals Review Unit at 416-397-0292.

Dental for Children – Ontario Works

Healthy Smiles Ontario covers the cost of dental treatments for children of parents who are receiving Ontario Works or Temporary Care Assistance. Treatments include services such as regular check-ups, cleanings and fillings. For questions about the program or replacement dental cards, call the Service Ontario INFOline at 1-844-296-6306 (TTY toll-free at 1-800-387-5559).

Dental Help for Adults and Children on ODSP

Families receiving Ontario Disability Support Program (ODSP)  are eligible for specific dental services through ACCERTA. Speak to your ODSP caseworker for details.

Through the Ontario Works dental program you may also get help with:

• dentures
• lab fees and exams
• replacements, repairs and relines

Note: You must let your dentist or denturist know that you are receiving assistance from the Ontario Disability Support Program, as they must get pre-approval for the denture services you need. Denture costs can not be reimbursed.

If you are receiving ODSP, have been denied dentures, and would like to appeal the decision, contact Employment and Social Services’ Appeals Review Unit at 416-397-0292.

View a list of eligible denture and emergency dental procedures.

Read related policies and procedures about Dental benefits.

Dental – Low Income Residents

Low-Income Residents Not On Social Assistance

Children aged 0 – 17

Families not receiving social assistance can contact Service Ontario or visit Healthy Smiles Ontario to find out if their children qualify for dental benefits. For questions about the program, call the Service Ontario INFOline at 1-844-296-6306 (TTY toll-free at 1-800-387-5559).

Toronto Public Health also provides some free dental and oral health services to eligible children.

Adults

Low-income Toronto adults aged 18 to 64 who need emergency dental treatments and/or dentures may be eligible for help through the Hardship Fund (see above). It is important that you apply before paying for any services, as you will not be reimbursed if you have already paid for them.

Toronto Public Health also provides some dental services.

Read related policies and procedures about Dental benefits.

Eyeglasses and Eye Exams

Glasses

Low-income Toronto residents and people on Ontario Works and may receive help to buy eyeglasses.

Eye exams

OHIP covers eye exams for people under 20 and people 65 and over. OHIP also covers eye exams for people between 20 and 65 who are receiving Ontario Works or Ontario Disability Support Program. You can get an eye exam once every 24 months if you are receiving social assistance. When you visit your optometrist or ophthalmologist, take your Ontario health card and Statement of Assistance

Who Can Apply

People receiving Ontario Works Assistance and low-income Toronto residents who cannot afford the cost of eyeglasses can apply for this benefit.

How To Apply

People receiving Ontario Works

Let your caseworker know that you have a prescription for eyeglasses. If you qualify, your caseworker will send you a voucher for a pair of eyeglasses, along with a list of locations where you can use it. The voucher is valid for 30 days and can only be used at these locations.

People not receiving social assistance

If you are not receiving Ontario Works benefits but you are a Toronto resident and cannot afford the cost of eyeglasses, you can apply for this benefit through Toronto’s Hardship Fund (see above). To apply you will need to show a copy of your prescription. If you qualify through the Hardship Fund you will be sent a voucher for a pair of eyeglasses, along with a list of locations where you can use it. The voucher is valid for 30 days and can only be used at these locations

Read related policies and procedures about Eyeglasses and Eye Exam benefits.

Funeral Expenses

Coverage for basic funeral expenses may be provided on behalf of deceased Toronto residents who do not have enough money in their estate to cover these costs.

Help with funeral expenses can include:

• Funeral services: Toronto Employment and Social Services will pay for the transfer of the body for cremation, burial, or for a traditional funeral service.
• Burial services: Toronto Employment and Social Services will purchase a burial plot. If the deceased person owned a plot, Toronto Employment and Social Services will pay to open and close the plot.
• Cremation services: Toronto Employment and Social Services will pay for cremation as well as the cost of scattering the remains in a cemetery or a burial in a pre-owned plot.

Who Can Apply

This benefit is available for those who pass away while receiving assistance from Ontario Works or Ontario Disability Support Program (ODSP), as well as for deceased Toronto residents who do not have enough money in their estate to cover funeral expenses.

The person responsible for making the funeral arrangements may apply for the funeral expenses.

How to Apply

If the deceased person was on Ontario Works or Ontario Disability Support Program, you can go directly to the funeral home of your choice. However, before making the funeral arrangements the Funeral Director must be told that the deceased was receiving social assistance. The Funeral Director will contact Toronto Employment and Social Services, Funeral Services Unit to obtain authorization.

If the deceased person was not receiving assistance from Ontario Works or the Ontario Disability Support Program, you can apply at any Employment and Social Services location. Contact an office to book an appointment and find out what information is needed to complete a funeral application. To determine eligibility, a caseworker will consider the financial situation of the deceased person and his/her spouse at the time of death. This includes, for example, assets, income, RRSPs and life insurance.

It is important you know that Toronto Employment and Social Services:

• must authorize services before you sign a contract with a funeral home or cemetery
• prefers that the executor/executrix start the funeral arrangements (If there is no executor/executrix, the person applying for this help should be the person making the arrangements at the funeral home.)
• is entitled to recover the funeral costs from all sources available to the deceased person
• is open between 8:30 a.m. –  5 p.m. Monday, Wednesday, Thursday, and Friday, and 8:30 a.m. – 6 p.m. on Tuesday. If the death occurs after hours or on a weekend/holiday, you must advise the Funeral Director that you plan to apply for financial help from Employment and Social Services

For more information, please contact Funeral Services at 416-338-8888 (select option 4) or contact one of our locations.

After Applying

The application for funeral expenses will be assessed immediately and, if eligible, authorization will be issued directly to the funeral home and/or cemetery. Coverage is limited to approved services and rates.

Toronto Employment and Social Services is entitled to recover any money paid for funeral services from assets/income of the deceased person. For example, bank accounts, Canada Pension Death Benefit or Life Insurance.

The Funeral Services Unit will mail a “Letter of Intent” to all recovery sources.

The Funeral Director’s ‘Statement of Death Certificate’ is kept by Employment and Social Services. If you require a copy of this certificate in order to administer the estate, or require further information, please contact Funeral Services at 416-338-8888 (select option 4).

Read related policies and procedures about Funeral benefits.

Medical Supplies and Devices

People receiving assistance from Ontario Works or the Ontario Disability Support Program (ODSP) and other low-income Toronto residents may receive help to pay for medical supplies, equipment and devices.

Medication

People on Ontario Works automatically qualify to have the cost of their prescription medications covered under the Ontario Drug Benefit Program.

Low-income Toronto residents not receiving social assistance can apply for help with drug costs through Toronto’s Hardship Fund (see above). If you have ongoing drug costs you will need to apply to the Trillium Drug Program for help.

While Receiving the Benefit: Low-Income Residents

If you qualify for the Hardship Fund, you can be reimbursed for eligible prescription medications.  If you have ongoing drug costs you will need to apply to the Trillium Drug Program for help.

While Receiving the Benefit: People on Ontario Works

Take your prescription and Ontario health card when you go to the pharmacy. The Ontario Drug Benefit program covers most medications. However, if you have a prescription for medication that the program does not cover, you can ask your doctor:

• to prescribe a different medication that is covered, or
• to send a request to the Ministry of Health to add your medication to the list of eligible drugs under the Ontario Drug Benefit Program.

People receiving social assistance can use their Ontario health card to access the Ontario Drug Benefit program. You should get an Ontario health card if you do not already have one.

Don’t have an Ontario health card?

Find out how to get an Ontario health card by visiting your nearest Service Ontario office or calling the ServiceOntario INFOline. It’s free.  Toll-free: 1-888-789-4199  TTY Toll-free: 1-800-387-5559. Find out how to replace or renew your health card at http://www.ontario.ca/healthcardrenewal

Not eligible to apply for an Ontario health card?

If you are not eligible for an Ontario health card, contact your Ontario Disability Support Program (ODSP), Assistance for Children with Severe Disabilities (ACSD) or Ontario Works office. You will get a paper drug eligibility card until you get your Ontario health card. For more information talk to your caseworker or visit your local social assistance office.

The Ministry of Health, Drug Programs Branch can be reached at:
5700 Yonge Street
3rd Floor
Toronto, Ontario
M2M 4K5
416-327-8109
1-866-811-9893 (toll-free)
TTY: 1-800-387-5559
DrugPrograms@moh.gov.on.ca

Support for Seniors – Ontario Works

Advanced Age Item

People on Ontario Works who are 65 years of age or older will receive an additional monthly amount to help cover the costs of personal needs due to advanced age.

An advanced age amount of $42/month is automatically added to the Ontario Works payment for those who are 65 years of age or older and not receiving Old Age Security.

Read related policies and procedures about Advanced Age Item.

Coverage for Guide Dogs – Ontario Works

People on Ontario Works may receive money towards the care and feeding costs of a certified guide, hearing or service dog.

This benefit amount is $84/month, with a yearly review.

Who Can Apply

People on Ontario Works who, due to a disability, have a specially trained dog certified for use as a guide, hearing or service dog can apply for this benefit.

How to Apply

To apply please speak to your caseworker.  You will need to provide your dog’s certificate from the accredited training facility or a registration card from the Ministry of the Attorney General.

An “accredited training facility” is:

• For guide dogs,
  • a facility that is listed in the Blind Person’s Rights Act,
  • a facility that is a member and meets the minimum standards of Assistance Dogs International, or
  • a facility that is a member and meets the minimum standards of the International Guide Dog Federation.
• For hearing and service dogs,
  • a facility that is a member and meets the minimum standards of Assistance Dogs International.

Read related policies and procedures about the Guide Dog Benefit.

Health Coverage When Leaving Ontario Works

People leaving Ontario Works because they are starting work or getting other income may continue to receive help with health costs for a period of time after they stop receiving monthly Ontario Works payments.

This can include:

• coverage of medication costs under the Ontario Drug Benefit Program
• Dental services and help with eyeglasses for children (and, in some cases, for adults)
• Help with medical transportation costs
• Help paying for medical supplies and special devices

Extended Employment Health Benefit

If you leave Ontario Works because of employment earnings, you may be eligible for the Extended Employment Health Benefit.

Who Can Apply

This benefit is for people who are leaving Ontario Works due to employment income. Your eligibility will depend on whether your employer covers your health benefits.

How to Apply

Speak to your caseworker if your file will be closing due to employment.

While Receiving

This is an ongoing benefit for up to 12 months.

Drug costs

For the first six months following the end of your Ontario Works payments, your medication costs will be covered under the Ontario Drug Benefit Program using your Ontario health card. If you continue to have medication costs, you should apply for coverage through the Trillium Drug Program. Ask your caseworker if you need help paying the Trillium Drug Program deductible.

Other medical benefits

For 12 months following the end of your Ontario Works payments, the cost of other medical benefits may be covered. Provide your caseworker with proof of what is required and how much it costs.

Read related policies and procedures about the Extended Employment Health Benefit.

Extended Health Benefit

If you leave Ontario Works because of other income, you may be eligible for the Extended Health Benefit.

Who Can Apply

This benefit is for people who are leaving Ontario Works due to income. Your eligibility will depend on the cost of the medically-based items you need and the amount of your income and assets.

How to Apply

Speak to your caseworker if your file will be closing due to income.

While Receiving

If you require a medical item within the first month of leaving Ontario Works, provide your caseworker with proof of the item you need. Your caseworker will let you know if you are eligible for coverage. If your file has been closed for longer than one month, you can apply for coverage through Toronto’s Hardship Fund.

Read related policies and procedures about the Extended Health Benefit.

Medical Transportation – Ontario Works

People on Ontario Works may receive money for transportation costs to attend medical appointments.

This is available if:

• you have regular appointments with a doctor, dentist or other health professional, or
• you are attending a drug or alcohol recovery program,
• your transportation costs are $15.00 per month or more, and
• your transportation costs are not already being covered

How to Apply

To apply please speak to your caseworker.

You will receive money based on the number of appointments you have each month. Give your caseworker a note from your doctor that shows how many appointments you attend.

If you cannot take public transit because of medical reasons, you can arrange for taxi service instead. Before you make taxi arrangements, ask your doctor to write in the note that, due to medical reasons, you need to take a taxi to your appointments.  Provide this note to your caseworker so that funds may be issued to you in advance of your medical appointments. It may be appropriate for you to apply to Wheel Trans or other driver assistance programs.

Other Details

Your medical transportation amount will be added to your monthly payment. This amount will be based on the number of appointments you have each month. The maximum monthly amount of medical transportation benefit that a person may receive when taking public transit cannot be more than the cost of a TTC metropass.

Medical transportation is reviewed every six months or when there is a change in the number of medical appointments, whichever occurs first.

Read related policies and procedures about Medical Transportation benefits.

Special Dietary Needs – Ontario Works

People on Ontario Works may be able to receive money to cover the additional cost of food required for specific medical conditions.

A Special Diet Allowance is available for conditions such as hypertension, diabetes and more. Also, pregnant women and mothers who are breast-feeding can get a nutritional allowance.

See a chart of the Special Diet Allowance amounts and which medical conditions qualify.

How to Apply

If you have a medical condition, please ask your caseworker for an Application for Special Diet Allowance form, which your health professional can fill out for you.

These health professionals can fill out the form:

• Physicians (doctors)
• Registered nurses in the Extended Class
• Registered dieticians, and
• Registered midwives or Traditional Aboriginal Midwives. (Midwives can only confirm special diet needs related to pregnancy or breast-feeding)

Within 90 days of your Special Diet Allowance ending, a letter and new Application for Special Diet Allowance form will be mailed to you.  You can reapply if necessary.

Your caseworker will review your eligibility for Special Diet Allowance at least once every 12 months.

Read related policies and procedures about Special Diet.

Other Health-Related Support for People on Social Assistance

The Ministry of Health and Long Term Care (MOHLTC) provides some health care services free of charge to people who receive Ontario Works.  Read coverage details for:

• Ambulance fees
• Dental care for children
• Eye exams
• Physiotherapy services at OHIP-funded clinics