Request a reimbursement for covered services
You can request the reimbursement of the cost of health services covered by the Health Insurance Plan. Certain conditions apply, such as being eligible when you received the services and having paid any related fees.
Situation for which you are applying for a reimbursement
Select the situation that applied to you to find out the reimbursement terms and conditions, if applicable.
You must present your valid Health Insurance Card to be entitled to covered services. If you fail to present your card or if it is expired, you will have to pay for the services. To find out how to renew an expired card, refer to the Renewal page. If necessary, you can replace a lost, stolen or deteriorated card.
You have one year after obtaining the services to apply for a reimbursement.
Reimbursement application procedure
- If your card is expired, make sure to renew it.
- Ask your doctor for the form entitled Demande de remboursement (carte expirée ou non présentée) or the form entitled Demande de remboursement d’une personne assurée from other health professionals.
- Follow the instructions on the form. There are 2 sections to fill out: one by the health professional and the other by you.
- Mail us your request for reimbursement at the address indicated on the form.
You can request a reimbursement from us if you believe that you were wrongfully billed by a Québec health professional (physician, dentist, optometrist or pharmacist). Refer to the Obtain information on covered services page for the services which may or may not be billed to you.
You have 5 years from the date on which you paid for the services to file a request. You must enclose a copy of each invoice or receipt given to you by the health professional or health facility. If you do not provide the required supporting documents, we will not be able to reimburse you.
Reimbursement application procedure
- Fill out and print the form Application for Reimbursement (accessory costs). Your Health Insurance Number is essential so that we may link your application to your record.
- Attach the following documents to your application:
- A copy of the detailed invoice given to you by the clinic or health professional
- Proof of payment (e.g. receipt, cash register slip)
- Mail us your application and supporting documents at the address indicated on the form.
Processing time is 60 working days after we have received the necessary documents. We will notify you in writing if we require more than 60 days for reasons beyond our control.
Coming into effect of the 5-year deadline
The 5-year deadline applies to requests for the reimbursement of fees that were wrongfully paid on or after December 7, 2015. Before this date, the deadline was 1 year.
The Québec Health Insurance Plan reimburses the cost of services covered outside Québec on certain conditions. For further information, consult the pages Request reimbursement for services received outside Québec and Know which services are covered outside Québec.
If you plan to receive health care outside Québec because the service you seek is unavailable in this province, please refer to the Medical services page.
Temporary stay in Québec
If you need health care in Québec, you have to present your health insurance card from your province of origin. Your health insurance plan will cover the cost of the services you receive in Québec.
Taking up residence permanently in Québec
Usually, you should become eligible for the Québec Health Insurance Plan on the first day of the third month following the date of your arrival in Québec. Please note that we do not reimburse the cost of health care received during the waiting period pending eligibility (the period from your arrival date to your eligibility start date). Therefore, you will have to present your health insurance card from your province of origin until the end of the waiting period pending eligibility.
Refusal of a health insurance card from another province
Some Québec health professionals practising in private health facilities do not accept the health insurance card of other provinces. In this case, you will have to pay for the services and then apply for a reimbursement with the health insurance plan of your province of origin. The situation is different if you receive the services in a hospital: the health facility will bill your province directly.
Reporting any wrongdoing
You can report situations that you find questionable. Here are some examples:
- Illegally billed fees
- Non-compliance with laws and regulations on the part of workers, health professionals or other service providers