Forming a New Couple

When two persons form a new couple (when the law considers them spouses), they must usually take certain steps to make sure they are covered by the right prescription drug insurance plan.

Check your situation to avoid unpleasant surprises

In Québec, everyone must be covered by prescription drug insurance at all times. By completing a short questionnaire, you will know in a few minutes under what time of plan (private or public) you should be covered and what steps you need to take, if any.

Persons covered by a private plan must obtain coverage under that plan for their spouse, at least for the prescription drug portion. Prescription drug coverage is most often included in a plan covering other health care (called a health insurance plan), but is sometimes offered alone.

However, these persons are not required to obtain coverage for their spouse if he or she is already covered by another private plan.

When one spouse is covered by a private plan and the other by the public plan

Persons covered by a private plan are required to obtain coverage under that plan for their spouse who, no longer being eligible for the public plan, must contact the Régie to cancel his or her public plan registration.

When one of the two spouses already has children

If the parents do not share the same domicile, the child must be covered by the private plan of the parent with whom he/she is domiciled. If that parent is not eligible for a private plan, the child must have coverage under the private plan of the other parent. A person may be eligible for a private plan through employment or through membership in a professional order or association.

If both parents are ineligible for a private plan, they must be registered for the public plan, under which their child will be covered as well.

However, if one of the parents becomes the spouse of a person eligible for a private plan, that parent must be covered by that plan, as must the parent's child if he/she is domiciled with the couple.

When both spouses are covered by a private plan

When both members of a couple are eligible separately for a private plan, they may join their respective private plans or they may both join the plan that best corresponds to their situation.

Neither spouse is allowed to be covered by the public plan. If one of them is mistakenly registered for the public plan, he or she must contact the Régie to cancel his or her registration.

When both spouses are covered by the public plan, administered by the Régie

When two persons covered by the public plan form a new couple, they are both allowed to retain their public plan coverage. They must, however, notify the Régie that they have become spouses.