In Québec, everyone must be covered by prescription drug insurance.
Two types of insurance plans offer this coverage:
- the public plan Public plan
The Public Prescription Drug Insurance Plan is administered by the Régie de l'assurance maladie du Québec and is intended for persons who are not eligible for a private group insurance plan covering prescription drugs, for persons age 65 or over, and for recipients of last-resort financial assistance and other holders of a claim slip (carnet de réclamation). Children of persons registered for the public plan are also covered by that plan., that is, the one administered by the Régie de l'assurance maladie du Québec;
- private plans Private plan
Private plans are usually available in the form of group insurance or employee benefit plans. Persons may be eligible for a private plan through employment, through membership in a professional order or association, or through their spouse or parents. Persons who are eligible for a private plan are required to join that plan. (group insurance or employee benefit plans).
Only those persons who are not eligible for a private plan may register for the Public Prescription Drug Insurance Plan. The Plan was set up in 1997 to cover all Quebecers who are not eligible for a private plan.
If you are eligible for a private plan, you must join that plan and provide coverage for your spouse Spouse
Two persons (of the opposite sex or the same sex) are considered spouses if they are married and have entered into a civil union, or have been living together for 12 months (separations of less than 90 days do not interrupt the 12-month period), or are living together (regardless of for how long) and together have had or have adopted a child. and children Children
Children are persons who are under age 18 or persons age 18 to 25 inclusive, are full-time students at an educational institution recognized by the Ministère de l'Éducation, du Loisir et du Sport, do not have a spouse and live with their parents. Persons age 18 or over are considered children if they are spouseless, have a functional impairment that began before age 18, are not receiving last-resort financial assistance benefits, and are domiciled with someone who would exercise parental authority over them if they were a minor..
A private plan is a group insurance or employee benefit plan offering basic coverage for prescription drugs. Plans of this type are called private plans because, unlike the public plan, administered by the Régie de l'assurance maladie du Québec, they are offered by private-sector companies.
Private plans are usually available through employment, in the form of group insurance, which an employer may offer to its employees as a fringe benefit. In addition, many professional orders and associations, as well as unions, make such plans available to their members.
Private plans are sometimes called healthcare plans or health insurance plans. Most private plans offer prescription drug coverage along with other services, such as paramedical services or consultations with certain health professionals (chiropractors, physiotherapists, dentists, etc.), but some offer prescription drug coverage only.
Coverage provided may vary from one private plan to another, depending on the agreement entered into between the policyholder Policyholder
A policyholder is the intermediary representing a group of people in the context of a group insurance contract. It may be an employer, a professional order or association, a union or a group of employees. and the insurance company or plan administrator.
However, in Québec, all private insurers Insurer (of persons)
A legal person that holds a permit issued by the Autorité des marchés financiers authorizing it to transact personal insurance in Québec and that assumes, in return for a premium paid, the financial consequences resulting from one or more risks specified in the contract signed by the parties. offering prescription drug insurance must fulfill minimum conditions regarding the coverage they provide and the financial participation they require of the persons they insure.