Vacationing outside Québec (2): what happens if I need healthcare?
If you are vacationing outside Québec and you have a valid Québec Health Insurance Card, you can receive the health services covered by the Régie de l’assurance maladie du Québec (RAMQ). Note, however, that RAMQ reimburses you for professional services at the rates that apply in Québec, even if you paid more than that out of pocket.
For services to be covered, certain conditions concerning the length of your stay outside Québec apply. These include the 183-day rule.
RAMQ does not cover certain care and services received outside Québec. That is why it is important that you take out private health insurance before you leave. Information about private insurance is available from the OmbudService for Life & Health Insurance.
If you receive healthcare in a private office or at a hospital and are covered by the Health Insurance Plan, you must present your Québec Health Insurance Card. If the doctor accepts your card, you have nothing to pay. RAMQ pays the doctor at the Québec rate for the services you receive.
However, if a doctor does not accept your Health Insurance Card, you must pay the doctor's fee. Keep the originals of your invoices and receipts (credit card payment slips, photocopies of cheques, etc.). You can then apply to RAMQ for a reimbursement. It will issue reimbursement at its own rates.
If you are hospitalized in a ward, generally you will have nothing to pay because the cost is fully covered by RAMQ under an interprovincial agreement. If a doctor charges you certain fees anyway, keep your documents (see the preceding paragraph).
RAMQ issues reimbursements for professional services at amounts not exceeding Québec rates for anyone who does not have private health insurance. However, it is strongly suggested that you take out such insurance before you leave. If you have private health insurance, you can ask the provider to send the invoice directly to your insurance company.
If you are hospitalized, RAMQ can reimburse you for certain fees at the pre-set rates. You must keep any relevant supporting documents. If you have private insurance, you can ask the provider to send the invoice to your insurer.
For more information
All the information you need is on RAMQ’s website.
If you have problems with RAMQ in claiming reimbursement, feel free to contact the Québec Ombudsman. We act at no cost, independently and without complicated red tape.
Have a healthy holiday in Québec or elsewhere!
Our preceding article: Vacationing outside Québec (1): what happens if I have a traffic accident?