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Exceptions to the Presence in Québec rule

To remain eligible for health insurance, you must be present in Québec. However, in certain exceptional situations, if you are a Québec resident, you may remain eligible despite an extended absence.

Useful to know before you leave

Québec residents normally lose their eligibility if they are absent from Québec 183 days or more in a given year. If you plan to be away from Québec for an extended period, call us before leaving to notify us of your absence. You may qualify for an exception to this rule if you are a Québec resident and in one of the following situations.

Calculating the number of days of absence

The total 183 days may result from one or several absences from Québec. Add up the days of absence, excluding absences of under 21 days and the days on which you depart and return.

Hospitalization outside Québec

You will remain eligible if you are unable to return to Québec because you are hospitalized or assisting someone who is hospitalized. In these situations, you must send us a medical certificate indicating the hospitalization start date and expected duration of your inability to return to Québec.

7-year provision

Once every 7 years, you are allowed to be away from Québec 183 days or more in a given calendar year (January 1 to December 31). This 7-year provision is authorized for personal reasons.

Find out before leaving whether you qualify. You will have to provide the planned dates of your departure and return, the reason for the trip, and the destination.

Do you plan to be absent from Québec for longer than the year granted under the 7-year provision? If you exceed 183 days of absence in the calendar year following that first year, you will lose your eligibility for health insurance for the entire second year. This means that you’ll have to pay for any health care received during that time.

  • Hold a valid Health Insurance Card
  • Have resided in Québec for at least 183 days following the date on which you became eligible for health insurance
  • Not have used the 7-year provision in the last 7 years

If your spouse or children are accompanying you, make sure that they also meet the requirements for the 7-year provision.

In the following table, Mary is away from Québec during several months to travel in the US. She is leaving on August 24, 2019 and will return on August 31, 2020. The days on which she departs and return are excluded from the calculation.

In 2019, Mary will have been absent 129 days, that is, under 183 days, which allows her to remain eligible for health insurance for that year. However, Mary is to return to Québec in August 2020, which is more than 183 days of absence in the following year of 2020. So, she decides to use the 7-year provision to remain eligible for that second year.

Mary’s trip to the US
Departure date (excluded from the calculation) Return date (excluded from the calculation) Number of days of absence Eligibility for health insurance
August 24, 2019 August 31, 2020 2019: 129 days (August 25, 2019 to December 31, 2019)

2020: 243 days (January 1, 2020 to August 30, 2020)
2019: maintained because the absence is under 183 days

2020: maintained because the 7 year provision is used for this absence totaling more than 183 days

Work, studies, training or internship outside Québec

You are allowed to spend more than 183 days per calendar year outside Québec if you are doing so to pursue work, studies, training or an internship outside Québec. Your coverage will be maintained and may also extend to the persons accompanying you (spouse, dependants) if they are eligible.

You remain eligible for health insurance if you are in one of the following situations:

  • Student enroled in an educational institution
  • Full-time unpaid trainee or intern
  • Québec government employee stationed outside Québec
  • Canada government civil servant stationed outside Québec
  • Person away in another province to pursue temporary work or a contract
  • Employee of a non-profit organization having its head office in Canada
  • Salaried employee or person pursuing a contract for a company or organization established in Québec
  • Self-employed worker carrying out a contract outside Québec
  • Person temporarily outside Québec within the scope of a social security agreement.

The duration of coverage and supporting documents required depend on the reason for your absence. To find out the procedure, as well as the terms and conditions that apply in your situation, refer to the webpage Inform RAMQ of a departure from Québec.

Travel insurance recommended

We recommend purchasing travel insurance. In general, health services covered outside of Québec are reimbursed in part by the Québec Health Insurance Plan. Travel insurance covers the part not reimbursed by RAMQ.

Application for review

You can apply for a review of a RAMQ decision. To find out more, refer to the page Request a review of a decision.

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