Prescription drug insurance
Persons who begin to work at a new job or for a new organization must usually take certain steps concerning their prescription drug insurance coverage.
When the employer offers a private plan
Some employers offer their employees the possibility of joining a private plan 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. (a group insurance or employee benefit plan). In such cases, the group plan administrator, who may be a human resources employee or an employee benefits specialist, usually gets in touch with the person and explains the various coverage options offered.
At that time, the employee must register for the plan offered, 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.
The employees are allowed not to join the plan offered only if they are already covered by another private plan offering prescription drug coverage (for example, through their 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. or through membership in a professional order or association). The employees must prove that they have such coverage by providing the employer with one of the following documents:
- a photocopy of their group insurance card;
- a form filled out by their spouse's employer, or an official letter from that employer on the company's or organization's letterhead;
- a letter or certificate from another employer or from the professional association or order to which they belong.
The employer will have to deduct the amount of the premium from the remuneration of employees who are unable to provide this proof.
Persons who have 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. coverage when starting a new job must contact the Régie to cancel their registration for that plan.
Persons who become eligible for a private plan are not allowed to remain covered by the public plan. If they don't cancel their public plan registration, they may have to reimburse the cost of any prescription drugs they obtained for themselves, their spouse or their children during the time they were required to be covered by the private plan for which they should have registered.
When the employer does not offer a private plan
Persons whose employer does not offer a private plan must determine whether they are eligible for a private plan through another means, for example, through their spouse or through membership in a professional order or association to which they belong.
Persons who are eligible for a private plan must join that plan, at least for the prescription drug portion. Otherwise, they must register for the public plan by contacting the Régie.
Maximum annual contribution
There is a maximum annual amount that insured persons may be required to pay for their drug purchases. As a general rule, the private insurer 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. or the Régie sees to it that this maximum is not exceeded. However, persons who change insurance plans and believe they will reach their maximum annual contribution before the end of the year must themselves inform their new insurer of the amount of their contributions.