All permanent residents of Québec must have prescription drug insurance. If you have access to a private plan (for example, through your employer, professional order or spouse), you are required join it. This means you are not covered by the public plan administered by the Régie de l’assurance maladie du Québec (RAMQ).
However, please note that on your 65th birthday, even if you have private insurance, the RAMQ will register you for the public plan. You should therefore consider your options and, ideally, make a decision before blowing out your candles.
Prescription drug insurance is not health insurance. To learn more about this second plan, which covers health services, visit the RAMQ website.
Your options when you turn 65
Individuals aged 65 and over who have access to private prescription drug insurance have three options.
1) Public insurance
Is the coverage available through the public plan enough for you? Contact your private insurer to cancel your policy. You do not need to take any action with the RAMQ. You will pay your annual premium when you file your income taxes unless you are eligible for free coverage.
Please note: if you choose the RAMQ and later change your mind, you may not be able to switch back to your private insurer. Contact your insurance company for the details of your policy.
2) Private insurance
Do you want private insurance only? This is an option if the coverage provided is at least equal to that of the public plan. The list of medications that must be covered is available online.
Be sure to inform the RAMQ of your decision before you turn 65. Then, on your income tax return, clearly indicate that you had private prescription drug insurance throughout the year.
3) Public insurance supplemented with private insurance
If you wish, you can supplement the coverage provided by the RAMQ with private insurance. That way, for certain expenses and medications not covered by the public plan, you can turn to your private insurance.
Please note that you will have to pay the premium for each plan.
When a person turns 65, the cost of their private prescription drug insurance often goes up. Make sure you have all the information before making your decision.
If you encounter any problems
If your complaint concerns a private plan, contact your insurance company’s ombudsperson or complaints office. You can also contact the Autorité des marchés financiers or the OmbudService for Life and Health Insurance (Ombudsman des assurances de personnes).
Are you dissatisfied with the RAMQ’s services, for example due to eligibility issues or delays? File a complaint with the Protecteur du citoyen. Our services are free of charge.
