Benefits Mandatory and Discretionary

Benefits - Mandatory and Discretionary

There are a number of benefits available to you if you are receiving social assistance. These are divided into two categories:

  • Mandatory Benefits: Benefits for which all recipients of social assistance are eligible.
  • Discretionary Benefits: Benefits that may be available to you depending on your circumstances.

Mandatory Benefits

There are many different mandatory benefits available to you, and some examples include:

  • Prescription Drug Coverage: Use your health card to access prescription drugs.
  • Dental: Adults to provide identification or an Ontario Works (OW) statement of assistance to the dentist for dental coverage according to prescribed limits. Children receive full coverage through Healthy Smiles. For more information, please see Dental and Denture Services.
  • Diabetic supplies
  • Surgical supplies and dressings

Discretionary Benefits

There are several benefits that may be available for you depending on your circumstances. Examples of these can include:

  • Employment-related expenses
  • Discretionary health related items: Typically a prescription, two cost estimates and a letter may be required from a medical professional detailing the detriment to the person’s health if the item being requested is not provided.
  • Funerals and Burials.

Eye Glasses and Eye Examinations

  • The Ontario Health Insurance Plan (OHIP) covers the cost of eye exams for people under age 20 and people 65 years and over.
  • For each member of the benefit unit who is between the ages of 20 and 64, Ontario Works will cover the cost of routine eye examinations once in every 24-month period.
  • Adults between the ages of 20 and 64 who have medical conditions requiring regular eye examinations (e.g. treatments for infection, disease or injury) receive coverage for these eye examinations once in every 12-month period under OHIP.

Clients must produce their Ontario Health Card to be eligible for a no-cost examination.

To receive eyeglasses:

  • Provide a copy of your prescription to your caseworker;
  • A purchase order is issued if eyeglasses are approved. Restrictions apply.

Appeals of Denied Benefits

You can appeal the denial of a mandatory benefit.

You cannot appeal if you are denied a discretionary benefit.

More Information on Benefits

The information above does not cover a complete list of available benefits. Clients who require assistance should contact their caseworker to discuss what is available to them. Clients will be notified in writing if they are approved or denied a benefit.