During a Trip or a Temporary Stay – In Canada
Professional services, up to amounts not exceeding Québec rates, and hospital services are covered in most cases. To receive these services, insured persons must present their valid Health Insurance Card.
Professional services
The professional services covered are those rendered by doctors, dentists and optometrists, as long as the same services are covered in Québec.
The Régie de l'assurance maladie issues reimbursements for professional services at amounts not exceeding Québec rates, even if the insured person paid more.
Procedure to follow
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. The Régie pays the doctor at the Québec rate for the services you receive.
However, a doctor who does not agree to be paid at the Québec rate might not accept your Health Insurance Card, in which case you must:
- pay the doctor's fee;
- keep the originals of your invoices and receipts (credit card payment slips or photocopies of both sides of your cancelled cheques showing the name of the hospital, doctor, dentist or optometrist);
- obtain an operative report from the doctor, if you underwent major surgery.
You can then apply to the Régie for a reimbursement. The amount reimbursed for professional services will be determined according to the rule explained in the boxed text above.
Hospital services
The hospital services covered are those insured under the Hospital Insurance Plan, specifically, services received during a hospital stay or at a hospital outpatient clinic. These include nursing care, diagnostic procedures, accommodation in a ward (a room with three or more beds) and prescription drugs administered during hospitalization.
You are not required to pay for hospital services you receive, because their cost is paid in full by the Régie de l'assurance maladie under an interprovincial agreement. Don't forget to present your Health Insurance Card.
Examples
The following examples show the amount payable by an insured person who:
Services not covered
Some services received outside Québec are not covered by the Health Insurance Plan. If you don't take out private insurance for these services before leaving Québec, you must pay their full cost yourself. Here are a few examples:
- any medical services not covered in Québec;
- services rendered by a health professional other than a doctor, a dentist or an optometrist;
- the cost of a private or semi-private hospital room;
- emergency transportation, by ground or air;
- the cost of bringing a person back to Québec;
- drugs purchased outside Québec, even if prescribed by a physician (before leaving Québec, persons who regularly take prescription drugs can ask their pharmacist whether they may obtain the drugs they will need during their absence).
