Prescription drug insurance: what happens after age 65?
Before age 65
Before your 65th birthday, you must join a private drug insurance plan if you have access to one (e.g. insurance plan offered by your employer). In such a case, you do not qualify for the Régie de l’assurance maladie du Québec (RAMQ) Public Prescription Drug Insurance Plan.
As soon as you turn 65, you no longer have to use a private plan if you had one before. You are automatically signed up for the public plan.
A few months before, RAMQ sends you a letter informing you that you have a choice to make:
- Public plan only
You opt for the public plan and notify your private insurer. You have no steps to take regarding RAMQ. You pay your annual premium when you file your income tax return.
- Public and private plan
You choose the public plan for basic coverage and keep your private plan for supplemental coverage. The public plan premium is payable when you file your tax return. The supplemental coverage is mainly for medication and fees that are not reimbursable under the public plan.
- Private plan only
You continue your contract with your private insurer. Generally, premiums increase when policyholders reach age 65. If you choose this option, you must contact RAMQ to deregister from the public plan. When filing your tax return, do not forget to indicate that you opted for a private plan.
As you near 65, make sure to be properly informed. Your choice will have a significant impact on your coverage and fees. The relevant information is on the RAMQ website. The deadline for contesting a RAMQ decision is six months after you have received the decision.
Please note: if you decide to keep your private insurance, do not forget to contact RAMQ before you reach 65. This way, you will not be automatically registered for the public plan.
Dissatisfied with RAMQ’s services, especially concerning eligibility and deadlines? Contact the Québec Ombudsman. Our services are confidential and free.
For complaints about your private plan, call your insurance company’s ombudsman or complaints office. You can also contact the Autorité des marchés financiers or the OmbudService for Life & Health Insurance.