Exceptional Access Program (EAP) - Ontario

A patient qualifies for the Exceptional Access Program (EAP) when they receive special authorization for coverage for a non-formulary drug by ODB. These claims must be submitted with an eligibility override so they are flagged and sent as an online ODB claim.

EAP is only available to patient enrolled in the Ontario Drug Benefit (DB) or Trillium (TR) program. For a patient to qualify under EAP, the patient's doctor must fill out the EAP form and submit it to the Exceptional Access Porgram.

To identify a prescription that is part of EAP:

1. In Rx Detail, select the Extended tab.
2. In the Prescription section, select the following checkboxes.
   • Section 8
   • Eligibility Override

   

   The Bill field in the Rx tab is updated to include DB.

3. Select Fill to process the prescription.