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  • 4931 87e 2020

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How to fill out the 4931 87e online

The 4931 87e form is an essential document used for requesting a re-assessment of your Trillium Drug Program annual deductible. This guide will provide clear, step-by-step instructions to help you complete the form accurately and efficiently online.

Follow the steps to fill out the 4931 87e form online.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Review the qualification criteria in Section 1 to ensure you meet all four requirements before proceeding.
  3. In Section 2, all household members aged 18 and older must complete the declarations. Ensure each person provides their signature and date.
  4. For Section 3, either refer to your 2015 Notice of Assessment as proof of income or complete the monthly income worksheet for each household member over 18, outlining expected income for each month in 2015.
  5. In Section 4, gather and attach necessary supporting documentation based on the types of income received by household members. Ensure all documents are included to prevent the request from being declined.
  6. Review all sections for completeness and accuracy before submitting the form. Make sure all information is correct and that all required signatures are provided.
  7. Finally, save your changes, then download, print, or share the completed form as necessary before sending it to the Trillium Drug Program at the provided address.

Begin your application process by completing the 4931 87e form online today.

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Your household must spend a certain amount on prescription drugs before you will become eligible to receive benefits. This amount is called the “deductible”. Your deductible is approximately 4% of your household's net income.

The TDP works with other medical insurance your household may have to help pay your eligible drug costs. The TDP will provide coverage after you have used all other sources of insurance, and after you have spent a certain amount out-of-pocket on eligible prescription drugs. This amount is called a deductible.

The Ontario plan covers the widest range of people, including seniors, children, the disabled and those on Ontario Works. The Trillium plan is more focused on those with lower incomes who have large prescription drug expenses every year.

If you're in a Canadian hospital (and you're eligible for government healthcare) prescription drugs are provided at no cost to you, under the Canada Health Act. If you're not in hospital, however, it's up to your province or territory to establish prescription drug coverage.

Trillium has a history of use for various gynecological conditions and for controlling postpartum bleeding. Trillium may have a role in topical control of bleeding and provide relief from insect bites and skin irritations.

Who is Eligible. Ontario residents (individuals or families) with valid Ontario Health Insurance (OHIP) may apply, regardless of their income, if they do not have private insurance or their private insurance does not cover 100% of their prescription drug costs.

The Ontario Drug Benefit program covers most of the cost of approximately 5,000 prescription drug products. It also helps you pay for: allergy shots and epinephrine injectable products (used in response to severe allergic reaction) some products used in monitoring and testing for diabetes.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232