The Régie de l'assurance maladie ensures that the only people who benefit from government-funded healthcare are those who eligible for the Health Insurance Plan. Thus, Health Insurance Card applications that appear non-compliant, and presumably fraudulent actions that are brought to the Régie's attention, are analyzed thoroughly and, in some cases, are investigated.
Generally speaking, in order for persons to benefit from the Health Insurance Plan, the law requires that they:
- have a status that makes them eligible;
- be domiciled in Québec;
- be absent from Québec for less than 183 days in a 12-month period.
The Régie carries out verifications to ensure compliance with these requirements. Any person who provides false information for the purpose of obtaining coverage may be found guilty of fraud.
Persons who commit such fraud:
- will have their registration for the Health Insurance Plan and the Public Prescription Drug Insurance Plan cancelled, if they are registered for those plans;
- will have to reimburse the sums that the Régie paid on their behalf, sums that may represent a considerable amount of money;
- may be the subject of legal proceedings.
How to report a fraudulent situation
To report a case of presumed fraud, contact the Régie.
Everyone can help protect the interests of persons eligible for the Health Insurance Plan.