Québec, like many other Canadian states, also offers free universal healthcare to all residents. In addition to Québec residents who don’t have private life insurance, people who come to study, or work temporarily in Québec are also eligible to register for health care under RAMQ (as long as they are legally allowed to stay in Québec).
To take advantage of any of the public healthcare facilities, you will need to apply for a Québec Health card. If you have decided to live in Québec permanently, you’re also required to obtain a prescription drug insurance plan as per Québec law. This is also covered by the RAMQ plan or can be obtained from your private health insurer.
Regardless of whether you stay in Québec permanently or temporarily, we highly recommend getting a RAMQ card. It is a cost-effective alternative to expensive private insurance plans and covers almost all emergency scenarios. Without the RAMQ card, you stand to be responsible for paying the total cost of any medical services you may require. Of course, once you have your Québec health card, you could ask for reimbursement from RAMQ, but the process can be long and taxing, taking up to three months to be processed.
Naturally, there are some exceptions to this, certain cases where a person can receive health care without having a valid health insurance card with them:
A RAMQ Health Card is given to every person enrolled in the RAMQ Health Care Plan. It has a unique 9-digit personal health number that hospitals, clinics and other medical facilities use to confirm your enrollment in the provincial healthcare plan. It also shows your name, passport number, and the expiry date of your enrollment in the healthcare plan itself.
Without the RAMQ Health Card, you may be invoiced for health services out of the territory and charged upfront -- so it is advisable to carry it at all times.
As we mentioned previously, applying for a RAMQ card is the first step in accessing free public health insurance. We recommend applying for RAMQ within fifteen days of arriving in Québec to avoid delays. You’ll need to complete the application form after verifying that you’re eligible and submit it to RAMQ in person or via post.
You are eligible for RAMQ Health Care if:
The registration process for Québec’s RAMQ is quite simple, and if you happen to be eligible for it, you can register as soon as you arrive.
In case you’re a native of one of the following countries with which Québec has signed a security agreement, you can certainly benefit from it. The purpose of this agreement is to benefit both Québeckers and residents of other countries to help them pay for health insurance coverage when they spend time temporarily or take up residence in either place.
These countries are:
One of the advantages of being a native to these countries is also the time it takes to get your RAMQ card since you have priority. If you’re not sure about your eligibility and belong to a country other than the ones listed above, you can check your eligibility for the RAMQ card on their website.
Under regular circumstances, you can visit the local RAMQ reception desk and ask for an application form and submit it right away with the required documents.
However, at the moment, because of the COVID-19 pandemic, Québec and Montreal reception desks are not available for visitors, and the only way to get an application form right now is through the mail.
Unfortunately, you can only apply for the Québec Health Card in person or via mail. Since the application form is not available online, you have the alternative to call the Québec reception desk and ask for an application form that will be mailed to you. They will also give you information on how to process your application correctly.
You can contact them by calling 418-646-4636, 514-864-3411, or 1-800-561-9749 (this number is toll-free).
To register for the Health Insurance Plan, you will need the following documents:
*All Documents in languages other than English or French will need to be translated before you submit your application.
After sending your application with the attached documents, you will receive a letter indicating whether your application was successful. Successful applications will also supply the date that the coverage begins.
Remember how we mentioned you get priority if your country has a security agreement with Québec? If you belong to any of those countries, your RAMQ card should arrive within thirty days after your application was sent. This thirty-day processing time is much faster than the 3 months waiting period which applies to newcomers to the province from other countries. Regardless of where you are from, you can apply for coverage for your children, spouse, other dependants, and even common-law partners with your application.
The province suggests you obtain private health insurance to cover you and your dependents while your applications are being processed since it’s mandatory to have some kind of insurance while staying in Québec.
It is of the utmost importance that you renew or replace your Health Insurance Card before it expires. In case it gets lost or damaged, you will also need to go through the same process.
As per Québec law, you may be asked to verify your identity when you:
Three months before your card expires, you should receive a Renewal Notice form from RAMQ. You have the option to visit either an SAAQ service outlet or a health network service point (CLSC) for a renewal application.
Note: You can visit the CLSC if you have only been residing in Québec for less than a year, or if your Renewal Notice is entitled “Renewal of Expired Card”.
What to Bring Along:
Once you have submitted your renewal application, it will take up to 10 days for your request to be processed. While renewal is done free of charge, it’s important to note that a surcharge of $25 applies for cards that had expired for more than six months at the time of the application.
In case your RAMQ card gets lost or stolen, you can request a replacement directly with the RAMQ. You can either call them at 1-800-561-9749 or use the online form here to reach them. It’s important to note that a fee for the replacement may apply.
You can request to have changes on your health insurance card if there’s information to be corrected, or if you happen to change your address.
We recommend notifying the SQCA desk if you plan to move out of Québec or change your residential address in advance. In either case, you must apply for an address change with the RAMQ within the first 30 days of your move.
You have two options available to change your address on the RAMQ card:
You will have to provide the following information:
The Québec health plan is intended to cover the full cost of certain medical services for people authorized to reside in Canada, as long as these services are offered by professionals who practise their profession within the scope of the provincial health plan coverage. Some examples of these are:
Also, this plan covers medical care at health facilities, such as:
If you have found yourself in a situation where you don’t have your RAMQ card, the RAMQ also offers reimbursement for covered services. You get an entire year to apply to be reimbursed, as long as you still have coverage under the public health plan at the time the incident occurred and the payment was made.
Even though the RAMQ covers a wide range of medical services, some services you require may not be included in their insurance plan. Health professionals who practice outside the scope of the plan can bill you for their services, and only the ones who are actively participating in the plan are likely not to do so.
The services covered by RAMQ may be provided in different places like hospitals, medical clinics, pharmacies, etc. They include:
Many pharmacy services are covered by the Québec Health Insurance Plan. These include:
As we mentioned before, if you reside in Québec permanently, it is mandatory to have prescription drug insurance coverage. You can opt from two available options:
It is important to remember that, as it is mandatory, you will automatically be eligible to receive coverage under the public plan if you don’t have access to a private one. Adults who opt for a private prescription plan will need to add their spouse and children to the same plan.
There are, however, some special provisions to protect the elderly and minors under this program. Anyone under the age of 18 living in Québec becomes invariably eligible for the public healthcare plan if their parents don’t have a private one, regardless of their residential status. If a minor resides in Québec for more than six months, they are also automatically qualified for the Public Prescription Drug Insurance Plan, even if their parents have a private one. Similarly, anyone over the age of 65 that doesn’t have a private plan automatically qualifies for eligibility.
To be able to receive covered services, you must present your Health Insurance Card. Otherwise, you will have to pay the total cost of the services and later apply for reimbursement.
It’s important to note that not all pharmacy services are covered and you are required to pay for others out of your pocket. These include:
Even when presenting your card, normally you will be asked to pay a small portion of the cost: this is your contribution to co-pay payments.
How does this work? There is a maximum contribution to the payment of covered drugs you must reach each month. Once this amount is reached, you will be able to obtain the remaining medications free of charge until the end of the month.
Some people are covered by the Public Prescription Drug Insurance Plan free of charge. These include:
Even when there are certain dental services covered by RAMQ at hospitals, you have to pay for tooth and root extractions. The only exceptions to these are cases of children under age 10 and recipients of last-resort financial assistance.
According to the Québec health insurance plan, oral surgery services covered by RAMQ include:
In addition to this, children under the age of ten receive the following services without a cost when administered at a dental clinic or a hospital in Québec:
Besides the services listed above, dental costs of the following services must be covered by you, regardless of your age or the location where these services are performed:
To be eligible as an international student for the Québec health plan, you need to:
Either way, international students are required to have health insurance while staying in Québec, and if for some reason you don’t qualify for the RAMQ, you are automatically registered for medical insurance from Sun Life Financial, the cost of which is applied to your school fees.
You may also opt to have private insurance coverage as long as it covers the entire duration of your stay in Québec.
If you are planning to travel outside Québec, you’ll still be able to receive healthcare services covered by your Québec Health Insurance Plan, but it’s important to note that in the majority of cases, RAMQ will reimburse only a part of the total cost. For this, you’ll need to keep the original receipts (credit card payment receipts showing the name of the hospital or health professional) and obtain an operative report (in case you had major surgery).
Whether you’re travelling outside Québec or Canada, the reimbursement for professional healthcare services will NOT exceed the Québec rates, even if you paid more for these services. On the other hand, if you need to be hospitalized and have private insurance, you can request that the bill be sent to your insurance company, which will claim the amount reimbursed by RAMQ. This is why it is recommendable to buy private travel insurance when travelling outside Québec, and especially when travelling outside Canada.
How does the reimbursement as per Québec rates work? To put it into perspective, imagine a scenario where you need to be hospitalized in say, Ontario for a femur fracture. Let’s say, the amount charged for this service is $928. RAMQ will only reimburse you for $422 as this is the maximum amount covered for this service in Québec. This means that you as a patient are responsible to pay $506 out of your pocket.
While that may still seem digestible, the out-of-pocket costs become much more significant if you’re travelling outside Canada, like in the USA, where the healthcare services are way more expensive. You’ll be responsible for almost the total cost and may require immediate cash payment.
To illustrate, emergency hospitalization in an ICU in Florida for a heart attack, including hospital services and professional services, can cost a whopping $26,000 for just three days. This same service in Québec is available for only $735; so the RAMQ will only be able to reimburse the $735 — which leaves you responsible for the remaining $25,265.
This data only makes a stronger case for why private health insurance is a much more preferable option when travelling outside Québec.
Not to mention some services are not covered by the RAMQ at all, for example:
When turning eighteen, you can continue to benefit from the Public Prescription Drug Insurance Plan as a dependent if you are pursuing full-time studies.
Students from ages eighteen to twenty-five who are enrolled as full-time students at the secondary, college, or university level get to have extended coverage if they meet the following requirements:
Please note that you might be asked to show proof of school attendance to verify you’re a full-time student. This proof must be provided by the educational institution, and it must indicate the student’s name, period of studies, and confirm that they are enrolled in full-time studies.
Under the Québec Healthcare Insurance Plan, seniors receive coverage for additional services, which are not available to others:
As soon as you turn sixty-five, you are automatically registered with the public plan, without having to take any action. Still, you may be eligible for a private insurance plan, and in this case, you have options and things to consider.
First, you must know that insurers offer two types of coverage:
It’s crucial to educate yourself about the kind of coverage you seek to make an informed decision. For instance, some people may opt for an insurance plan that covers visits to a naturopathic clinic or an acupuncturist, provides additional coverage for prescription drugs and medical services, and also covers additional costs such as funeral expenses and the costs of these before making a final decision. The best thing you can do is contact your insurer and ask any questions you may have because certain contracts establish that the decision to waive private plan coverage is irrevocable.
In case you choose to join a private-only plan, you have to let the RAMQ know before you turn 65. Otherwise, you will automatically be registered for a public one, which may conflict with your contract with your private insurer.
Despite its popularity and the fact that the Régie de l’assurance maladie du Québec (RAMQ) covers a lot of the general medical expenses, some services are not included in their insurance.
Some of them are only covered partially and others aren’t covered at all. It’s important to know what these services are.
Also, some factors influence whether you are covered by the RAMQ, like your age, and whether or not you are a recipient of financial assistance of last resort.
The services that are typically not covered by RAMQ are:
If you need medical services that are beyond the scope of RAMQ, there’s always an option for you to extend the coverage that RAMQ provides through Extended Health Care benefits.
This means you can get major medical benefits that the government plan doesn’t cover in addition to your existing health insurance.
Why is it a good option? These kinds of extended plans provide you protection against high-cost medical services and treatments that public life insurance doesn’t cover.
This includes services like:
Remember that this is meant to supplement your RAMQ Health Coverage Plan, and not replace it. Typically, you’ll need to cover the expenses of your treatment first and file for reimbursement with your insurer later. The amount spent on covered services will be reimbursed to you in full later by your insurer.
This type of insurance coverage can be obtained individually or under a group plan. What’s the difference between these two options? Primarily the amount of money you pay. Since employers who provide health insurance to their employees are required to cover a minimum of 50% of the total insurance cost, you will only have to pay the remaining percentage.
In the case of individual insurance, you’ll have to cover the total cost, since there is no one to share it with. This individual extended health care is ideal for people who work as freelancers and don’t have an employer.
Although the Québec health plan covers a lot of the basic health services, you may find yourself at risk of having to pay huge medical expenses out of pocket, especially if you’re someone who travels a lot within and outside of Canada. Many people with health conditions that require visits to health practitioners such as psychologists, osteopaths, acupuncturists, massage therapists, naturopaths, or more may also require additional coverage.
On the other hand, in comparison to other countries, Canada has one of the best public health insurance systems in the world — And the Québec Health Care Card coupled with extended healthcare plans can help you make full use of it. Ultimately, you must decide if you require extended coverage and are willing to pay a small premium for that peace of mind.
Whatever you decide, if you need help picking insurance plans, we at Insurdinary can help you select one that fits your family’s health needs the best. Don’t hesitate to reach out to us if you have any concerns!