Prescription Drugs Covered

Prescription drug coverage offered by private plans may differ from one plan to another, but must correspond to that of the public plan, administered by the Régie de l'assurance maladie du Québec.

All private insurers must therefore cover at least the drugs listed on the List of Medications, which is drawn up and updated by the Minister of Health and Social Services after consultation with the Conseil du médicament and is published periodically on the Régie's website.

Exception drugs and the exception patient measure

Exception drugs are covered by private plans under certain conditions. In this regard, the insured person or that person's doctor must send the insurer an application for a payment authorization for an exception drug. Once the payment authorization is granted, the person concerned can obtain the drug by presenting his/her prescription to the pharmacist and paying the required contribution, just as when purchasing any other drug covered by a private plan.

For treatment of a serious medical condition, the exception patient measure may cover, on an exceptional basis, drugs not listed on the List of Medications. However, in such cases certain criteria must be fulfilled. If a payment authorization is granted, the drug is automatically covered and the person concerned can obtain it by paying the contribution required by his/her private plan.