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Important notice

COVID-19: Answers to your questions

Certain services are available by appointment only at our Montréal and Québec reception desks. No one without an appointment will be seen. For a list of the services offered by appointment, or if you have any questions, refer to the webpage Questions and answers about our services during the pandemic.

Statement of services

Our statement of services reflects our commitments towards citizens. It expresses our concern with providing you with services that meet your expectations.

Our mandates

Our mission consists in ensuring sound management of the various plans we administer. In doing so, we are guided by our values of equity, integrity and respect:

  • Managing insured persons’ eligibility
  • Remunerating health professionals
  • Informing you
  • Ensuring adequate controls
  • Ensuring secure sharing of health information
  • Making it easier for you to access health services

Our core services

  • Managing the eligibility of persons for the Québec Health Insurance Plan
  • Providing coverage for the health care and services available under the plan
  • Producing and issuing Health Insurance Cards

We administer programs targeting certain needs:

  • Visual impairment
  • Hearing impairment
  • Loss of an eye
  • Mastectomy
  • Stoma
  • Lymphedema
  • Physical impairment
  • Medical and hospital services received outside Québec

We establish the financial contribution or exemption applied toward the cost of:

  • Domestic help services
  • Accommodation in a public facility
  • Accommodation in an intermediary resource

We make certain online services available to you. With them, you can:

  • Have your lost, stolen or damaged Health Insurance Card replaced
  • Register or deregister with the Public Prescription Drug Insurance Plan
  • Order the forms to register for organ and tissue donation and advance medical directives
  • Schedule an appointment with a family doctor
  • Register with the Québec Family Doctor Finder
  • Consult your health information in the Québec Health Booklet

Our general commitments towards you

Courtesy

Treating you with respect and attentiveness

Competence

  • Providing the information you need while making sure that you understand it
  • Conveying clear, complete and accurate information to you

Equity

Treating you fairly when we assess your requests and respond to them

Accessibility

  • Making sure that your efforts to obtain our services are simple
  • Providing you with accessible and effective service
  • Ensuring that our website contains all the information you need to benefit from our programs and services
  • Providing answers suitable to your situation

Concern for your needs

  • Consulting you to find out your needs and expectations
  • Taking into account your comments, suggestions and criticisms to improve our products and services

Our specific commitments

We have set standards for serving you in a timely manner. Barring certain exceptional situations, we strive to:

  • answer your call within 3 minutes’ time
  • meet you within 30 minutes when you come to our offices
  • send you your Health Insurance Card within 10 working days after receiving your complete application

We undertake to process your requests for reimbursement within 60 working days following the receipt of the required documents. These include the reimbursement of costs:

  • Billed illegally to you by a health professional (accessory costs)
  • Billed to you by a health professional other than a pharmacist in the event where you did not present your valid Health Insurance Card
  • Incurred for services received outside Québec
  • Incurred within the scope of one of our financial assistance programs:
    • External Breastforms Program
    • Ostomy Appliances Program
    • Program Regarding Bandages and Compression Garments Used to Treat Lymphedema
    • Ocular Prostheses Program

If for reasons beyond our control, the processing time for your request for reimbursement of fees billed to you exceeds 60 working days, we will explain why and provide you with a revised completion date.

Below are the timeframes you can expect in normal circumstances when we receive an authorization request for an exceptional medication for a therapeutic indication appearing in Appendix IV to the List of medications.

Service offertTimeframe
Exceptional medication25 working days
Exceptional medication required on a priority basis such drugs are marked with a star in Appendix IV to the List of medications1 working day

We undertake to do our utmost to render a decision within the set timeframes, when the information initially received is sufficient. If we require additional information from your prescriber, we will let you know. The timeframes exclude any period of time when we are waiting for information from your prescriber.

The processing times may be longer for more complex requests. If the processing time of your request for a medication that is not required on a priority basis is expected to exceed 25 working days, we will notify you accordingly.

Your responsibilities

Your cooperation is key to enabling us to carry out our commitments. Anytime you submit a request to us, we are counting on you to:

  • Provide us with complete, accurate and up-to-date information
  • Send us, before the set deadline, the information and documents that we require
  • Inform us, as soon as possible, of any change that could have a bearing on your request or your file

Confidentiality

In compliance with the legislation governing us, we ensure the confidentiality of all personal information entrusted to us and allow its use strictly in keeping with the law.

Assessing how we’re doing

Each year, we report on the results of our efforts to meet our commitments in our annual management report (French only). In addition, we regularly conduct consultations to measure your satisfaction with our services. This allows us to adjust our services according to your needs and expectations.

We value your opinion

Despite our best efforts to provide you quality services, you may be dissatisfied with a service that you received. You can make your comments, suggestions and complaints know to the Commissioner for Insured Persons’ Complaints This official undertakes to respond to you within 2 working days and to process any complaint within 30 days. For further information, refer to the page Give my opinion on the quality of services provided.