Everything you need to know about accessing Ozempic in Ontario, including costs, coverage, and eligibility
Ozempic has become one of the most talked-about medications in Canada, especially in Ontario. Whether you’re managing type 2 diabetes or looking for weight management solutions, many patients are wondering the same thing:
Is Ozempic covered by OHIP?
Is Ozempic free in Ontario?
What does it cost out of pocket?
At Viva Health Pharmacy, we’re here to help you navigate your options with clarity and confidence. Here’s a complete 2025 guide for those living in Ontario—especially Richmond Hill—on how to access Ozempic, what OHIP covers, and how pharmacists can support you through the process.
What is Ozempic?
Ozempic (semaglutide) is a once-weekly injectable medication approved to:
- Improve blood sugar control in adults with type 2 diabetes
- Lower the risk of major cardiovascular events (such as heart attack or stroke)
- Support weight loss in patients with or without diabetes (off-label)
It belongs to a class of drugs called GLP-1 receptor agonists, which help regulate insulin, slow digestion, and reduce appetite.
🔍 Note: While many patients explore Ozempic for weight loss, its primary approval in Canada is for type 2 diabetes.
Is Ozempic Covered by OHIP in Ontario?
Here’s the short answer:
Ozempic is covered by OHIP—but only under specific conditions.Who qualifies for OHIP coverage?
Ozempic is listed under the Ontario Drug Benefit (ODB) program, which provides coverage to:
- Seniors aged 65 and older
- Individuals on the Trillium Drug Program (TDP)
- Recipients of Ontario Works or ODSP
- Residents of long-term care homes
- Individuals enrolled in the Home Care or Ontario Disability Support Program
However, coverage is not automatic—it is subject to something called Limited Use criteria.
What is Limited Use Coverage?
To get Ozempic covered under OHIP, your doctor must confirm that:
- You have type 2 diabetes not controlled with metformin alone
- You are at high risk for cardiovascular disease, or
- You’ve tried and failed on other diabetes medications
Your doctor will fill out a LU (Limited Use) code on your prescription to activate OHIP coverage.
What is Limited Use Coverage?
To get Ozempic covered under OHIP, your doctor must confirm that:
- You have type 2 diabetes not controlled with metformin alone
- You are at high risk for cardiovascular disease, or
- You’ve tried and failed on other diabetes medications
Your doctor will fill out a LU (Limited Use) code on your prescription to activate OHIP coverage.
⚠️ OHIP does not cover Ozempic for weight loss alone, unless related to diabetes management.
How Much Does Ozempic Cost Without OHIP?
If you’re not eligible for OHIP coverage, the cost of Ozempic can be significant:
Dose Quantity Approx. Cost (CAD) 0.25 mg / 0.5 mg 1 pen (4 doses) $225 – $240 1 mg 1 pen (4 doses) $300 – $340 2 mg 1 pen (4 doses) $360 – $400 💡 Tip: Many private insurance plans do cover Ozempic—check with your provider.
Is Ozempic Free in Ontario?
Yes, but only for some.
If you’re part of the ODB, ODSP, or Trillium programs and your doctor prescribes it under Limited Use, you may receive Ozempic for free or with a small co-pay (as low as $2 per prescription).If you don’t qualify, it will be an out-of-pocket expense—unless covered by your private or workplace insurance.
How to Access Ozempic with OHIP
- Talk to your doctor
- Discuss if Ozempic is appropriate for your diabetes treatment
- Ensure you meet the Limited Use criteria
- Get a prescription
- Your doctor must indicate the LU code if applying through OHIP
- Bring the prescription to Viva Health Pharmacy
- Our pharmacists will check your OHIP eligibility
- We’ll submit it through your ODB, Trillium, or other plan
- Ask about support options
- Don’t qualify? We’ll help you find savings programs or alternate therapies
Alternatives to Ozempic (If Not Covered)
If you don’t qualify for Ozempic coverage through OHIP, ask your pharmacist or doctor about:
- Rybelsus (oral semaglutide)
- Trulicity
- Bydureon
- Metformin + SGLT2 inhibitors (e.g. Jardiance, Farxiga)
- Compounded semaglutide (not approved but offered privately)
⚠️ Weight loss-specific prescriptions of Ozempic are not covered by OHIP at this time.
FAQ – Common Questions About Ozempic Coverage in Ontario
Can I use OHIP to get Ozempic for weight loss?
No. OHIP only covers Ozempic for diabetes, not obesity or weight management.Is Trillium Drug Program coverage different?
No. Trillium still uses the same Limited Use criteria as OHIP. But co-pays may vary.Can pharmacists help me access Ozempic?
Yes! At Viva Health Pharmacy, our pharmacists can:
- Review your insurance options
- Help coordinate LU forms with your doctor
- Set up refill reminders and injection training
Can I switch from another GLP-1 to Ozempic?
Yes, with your doctor’s recommendation and an updated prescription.Helpful Resources
- Ontario Drug Benefit Program – Limited Use Drugs
- Trillium Drug Program Info
- Health Canada – Ozempic Product Monograph
- Contact Viva Health Pharmacy
📞 Need Help Getting Ozempic?
We’re here to support you every step of the way.
📍 Visit us at: 9580 Yonge St, Unit 5, Richmond Hill
📞 Call: 905-237-5567
📩 Email: info@vivahealthpharmacy.com
