Fees billed at the hospital or at the clinic: allowed or not?

  • November 8, 2023
  • Prescription drug insurance, Health insurance, Accessory costs, Hospital
Man chatting with health clinic receptionist about a misunderstood bill.

Since 2017, accessory costs (costs related to services covered by the public health insurance plan) have been prohibited. Even so, you may have to pay certain fees. Here’s what you need to know.

Free services

The cost of many health services is covered, meaning the fees are paid by the Régie de l’assurance maladie du Québec (RAMQ) for insured people. These services can be offered in a hospital, a medical clinic, a CLSC, etc. 

To be covered, these services must be medically required for an insured person for preventive or curative purposes. The services must be provided by a recognized health professional, namely:

All fees in connection with a free service, including administrative fees, are also covered. You cannot be charged for these costs, for example, for:

A single exception: You might be asked to pay $15 for the transport of blood samples, or $5 for all other types of samples.

Billable services

Certain services are not covered by the public plan. You will therefore be billed for them.

Uncovered services include those that are not needed for your health condition, for example:

In addition, certain services are not covered in clinics, but are covered in hospitals, such as:

Did you miss a medical appointment? In certain cases, you could be billed.

Need information or help?

To learn more about health service coverage, go to RAMQ’s website.

Do you want to contest fees charged by a hospital? Contact the institution’s service quality and complaints commissioner. If the fees you’re contesting were charged by a clinic, contact RAMQ.

If you’re dissatisfied with RAMQ procedure or if the commissioner hasn’t gotten back to you within 45 days, contact the Québec Ombudsman. Our services are free and confidential.

For more information about the recourse available to you, see the article titled Filing a health network complaint in the public or private sector.

Also see: Hospitalization: what rooms cost