Turning 65
Persons who
turn 65 are automatically
registered for the public plan,
administered by the Régie. They
therefore have no steps to take.
About
private plans
Many private
insurers continue to offer
prescription drug coverage to
persons age 65 or over who were
already covered by such a plan.
Two types of coverage may be
available to them: basic
coverage (at least equal to the
coverage provided by the Régie)
and supplemental coverage (in
addition to the coverage
provided by the Régie).
When persons
who turn 65 remain eligible for
a private plan offering basic
prescription drug coverage, they
have a choice to make. They may
decide to be insured:
- only by the public plan, administered by the Régie;
- by the public plan (first payer) and by a
private plan offering supplemental coverage (second payer); or
- only by a private plan offering at least the basic coverage.
Before
deciding, they must ask their
private insurer about the
various options available and
their cost.
Joining only the public plan
Persons who choose to join only the public plan don't have to contact the Régie. They must, however, be aware that in some insurance contracts a person's decision to give up private plan coverage is irrevocable.
Persons
insured by the public plan must
indicate on their income tax
return that they were covered by
that plan during the year and
must pay the
premium applicable to their
situation. To find out the
amount of their premium, they
must complete Attachment K to
their Québec income tax return.
Joining the public plan and
retaining the supplemental
coverage offered by a private
plan
When a person turns 65 and
remains eligible for a private
plan offering prescription drug
coverage, the amount of the
person's premium usually
increases. In most cases, the
person chooses to join the
public plan, administered by the
Régie, to obtain basic coverage.
The person may also wish to take
out supplemental coverage
offered by his or her private
insurer.
Supplemental coverage does not
replace the basic coverage of
the public plan, but may add to
such coverage, for example, by
paying the cost of drugs not
insured or the portion of costs
not reimbursed by the public
plan. When a person has
supplemental coverage for
prescription drugs, the Régie
acts as the first payer and the
private plan as the second
payer.
Persons who
have basic coverage under the
public plan and supplemental
coverage under a private
plan must indicate on their
income tax return that they were
covered by the public plan
during the year. Since they had
basic coverage under that plan,
they must pay the
premium applicable to their
situation. To find out the
amount of their premium, they
must complete Attachment K to
their Québec income tax return.
Retaining only the basic
coverage of a private plan
Persons who choose to retain the
basic coverage of their private
plan must
contact the Régie to
cancel
their automatic public plan
registration. Otherwise, they
would be covered by two basic
plans, which is prohibited under
the
Act respecting prescription drug
insurance. Before cancelling their public
plan registration, they must
make sure their private plan
indeed offers basic coverage at
least equal to that provided by
the Régie.
Persons who
have basic coverage under
a private plan must indicate on
their income tax return that
they were covered by a private
plan during the entire year.
They don't pay the public plan
premium.
