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:
- A physician, a dentist, a pharmacist or an optometrist who participates in the public plan.
- Another health professional only if they work within an institution (hospital, rehabilitation centre or CHSLD, for example).
All fees in connection with a free service, including administrative fees, are also covered. You cannot be charged for these costs, for example, for:
- Opening a file;
- Cortisone or analgesic injections;
- Changing a bandage;
- X-rays;
- Medical examination;
- Urine or blood sugar test;
- Replacing a lost prescription;
- Record keeping or writing up a medical report;
- Copying or transferring a medical file to another participating physician.
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:
- A medical test or form required by your insurer, employer or the Société de l’Assurance automobile du Québec (SAAQ);
- Services provided for cosmetic reasons.
In addition, certain services are not covered in clinics, but are covered in hospitals, such as:
- Certain kinds of imaging (e.g. some ultrasounds, CAT scans and MRIs);
- Acupuncture, audiology, chiropractic, occupational therapy, physical therapy, and psychology services;
- Services from professionals (including physicians) who do not participate in the public plan. These professionals must inform you about their status when you consult them.
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 Protecteur du citoyen. 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
