Ozempic has become one of Canada’s most talked-about prescription medications — both for its effectiveness in managing Type 2 diabetes and its impact on weight loss.
But with the rising cost of GLP-1 drugs, many Ontarians are asking a practical question:
Is Ozempic covered by OHIP?
In this article, we’ll clarify how coverage works in Ontario, when Ozempic is funded through public programs, and what options are available if you’re paying out of pocket.
What Is Ozempic?
Ozempic (semaglutide) is a once-weekly injectable medication developed by Novo Nordisk.
It belongs to a class of drugs called GLP-1 receptor agonists, which help the body regulate blood sugar and appetite by mimicking natural gut hormones.
Ozempic is primarily approved for adults with Type 2 diabetes to:
- Improve blood-sugar control
- Reduce the risk of heart-related complications
- Support gradual, healthy weight loss as a secondary benefit
Although many patients without diabetes use Ozempic for weight management, that particular use is off-label — meaning it’s not the purpose for which OHIP provides coverage.
How OHIP Drug Coverage Works
The Ontario Health Insurance Plan (OHIP) itself doesn’t directly pay for prescription drugs in most cases.
Instead, coverage for medications comes through a companion program called the Ontario Drug Benefit (ODB).
You may qualify for ODB coverage if you are:
- 65 years of age or older
- Living in a long-term-care or special-care home
- Receiving professional home-care services
- Receiving Ontario Works or Ontario Disability Support Program (ODSP) benefits
- Enrolled in the Trillium Drug Program (for families with high medication costs relative to income)
Only drugs listed on Ontario’s Formulary — the province’s official list of publicly funded medications — are eligible for reimbursement under these programs.
Is Ozempic Listed on the Ontario Formulary?
Yes — but only for specific medical use.
Ozempic is listed as a Limited Use (LU) product on the Ontario Drug Benefit Formulary.
This means it’s covered only for patients with Type 2 diabetes who meet certain clinical criteria, such as:
- Inadequate blood-sugar control using metformin and/or sulfonylureas
- Need for an additional medication to manage diabetes and cardiovascular risk
To qualify, your prescriber must include the LU code on your prescription. Your pharmacist then uses that code to process the claim through the public drug plan.
If you’re using Ozempic solely for weight loss, OHIP will not cover the cost, even if you’re eligible for other ODB benefits.
Average Cost of Ozempic in Ontario
Without insurance, the cost of Ozempic in Ontario is approximately $250 – $400 per month, depending on dosage and pharmacy location.
Your local pharmacy in Richmond Hill can provide a precise quote and check if your insurance plan covers part of the expense.
Many private or employer insurance plans include Ozempic under their diabetes-care or metabolic-health drug categories.
OHIP Coverage vs. Trillium Drug Program
For patients who don’t have private insurance, the Trillium Drug Program can be a valuable option.
This program helps Ontario residents whose annual prescription costs are high compared with household income.
Here’s how it works:
- You pay a yearly deductible based on your income (divided into four quarterly payments).
- Once the deductible is met, the province covers most eligible drug costs for the rest of the benefit year.
Since Ozempic is listed on the Formulary, it can be covered through Trillium if prescribed for Type 2 diabetes and accompanied by the correct LU code.
Your pharmacist can help you verify eligibility and guide you through the application process.
Private Insurance and Combination Coverage
If you have an employer health plan or individual insurance, your provider may reimburse part of your Ozempic cost — even for off-label weight-management use.
Combining private coverage with public options like Trillium can reduce out-of-pocket expenses further.
At Viva Health Pharmacy in Richmond Hill, our team regularly assists patients in coordinating multiple coverage sources to ensure the most affordable access.
When OHIP Doesn’t Cover Ozempic
If you do not have Type 2 diabetes or your doctor prescribes Ozempic primarily for weight management, the cost will be your responsibility unless a private plan agrees to pay for it.
In such cases, pharmacists may suggest:
- Alternative GLP-1 options such as Wegovy (specifically approved for weight management, though not OHIP-funded yet)
- Lifestyle and nutritional guidance to support your goals safely
- Enrollment in manufacturer assistance programs offered by Novo Nordisk for eligible patients
Accessing Ozempic Through a Richmond Hill Pharmacy
Due to national demand, supply can fluctuate across Canada.
Local pharmacies often maintain wait-lists or coordinate with suppliers to ensure consistent availability for existing patients.
At Viva Health Pharmacy in Richmond Hill, we:
- Verify coverage through OHIP, Trillium, or private insurers
- Help patients understand prescription criteria and LU codes
- Provide education on correct injection technique, storage, and dose titration
- Offer reminders for refills to prevent treatment interruptions
Our goal is to make access to medications like Ozempic safe, transparent, and affordable for every patient.
Practical Tips for Patients
- Ask your prescriber whether you qualify under the OHIP Limited Use criteria.
- Bring your insurance card and any Trillium confirmation letters to the pharmacy.
- Track your blood-sugar readings regularly — they support future renewal approvals.
- Check costs monthly; price fluctuations can occur due to manufacturer supply changes.
- Stay in touch with your pharmacist for dosage reviews and side-effect management.
Ozempic is an effective medication for both diabetes management and weight control.
However, OHIP covers it only for patients treating Type 2 diabetes under specific conditions.
If you’re considering Ozempic, speak with your doctor about your health goals and coverage eligibility.
Your Viva Health Pharmacy team in Richmond Hill can help verify your plan, explore cost-saving programs, and ensure you receive continuous, expert care.
