Prescription drug insurance
Children remain covered by their parents' plan until their 18th birthday, at which time they or their parents must take certain steps.
Generally speaking, children who turn 18 must remain covered by their parents' plan if they meet the following conditions:
- they are full-time students in an educational institution at the secondary, college or university level
- they do not have a spouse Spouse
Two persons (of the opposite sex or the same sex) are considered spouses if they are: (1) married and have entered into a civil union (2) have been living together for 12 months (separations of less than 90 days do not interrupt the 12-month period) (3) are living together (regardless of for how long) and together have had or have adopted a child.
- they are domiciled with their parents
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 type of plan (private or public) you should be covered and what steps you need to take, if any.
When a child covered by a private plan turns 18, the insurer Insurer
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. will usually extend the child's coverage automatically. However, when a child covered by the public plan reaches that age, the parents must contact the Régie to have the child's coverage extended. Private insurers and the Régie may check to make sure the child is indeed a full-time student.
The Régie may request proof of school attendance issued by an educational institution at the secondary, college or university level. The proof must show the child's identity, indicate the period of studies and confirm that the studies are full-time.
The child will remain covered by his or her parents' plan until his or her 26th birthday. However if, between ages 18 and 25, a child ceases to meet either of the above conditions, even temporarily, the child or the child's parents must notify the private insurer or the Régie, which in most cases will terminate the child's coverage.
Exception to the rule
Full-time students age 18 to 25 who do not have a spouse and who are eligible for a private plan (for example, through employment held while attending school) may no longer benefit from their parents' public plan coverage. This is because persons who become eligible for a private plan must immediately join that plan. In such cases, the parents or the child must contact the Régie to cancel the child's registration for the public plan.
Persons who cease to be covered by their parents' plan (at age 18, age 26, or between these ages)
Persons age 18 or over must check whether they are eligible for a private plan as soon as their situation changes (starting a new job, joining a professional order, having a new spouse, etc.).
Private plan coverage is available either through employment, through membership in a professional order or association, or through one's spouse or parents. In fact, those persons covered by a private plan are required to obtain coverage under it for their spouse and children, unless their spouse and children are already covered by another private plan.
Persons who are eligible for a private plan must join that plan, 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.
Persons who are not eligible for a private plan must register for the public plan, by contacting the Régie, in which case they will no longer be registered as a child of an insured person, but rather as an adult.