Last-resort financial assistance (social assistance)
When someone become a recipient of last-resort financial assistance, they are automatically registered with the Public Prescription Drug Insurance Plan. However, when they cease to be a recipient, they must take steps concerning their prescription drug insurance coverage.
Becoming a recipient of last-resort financial assistance
When a person becomes a recipient of last-resort financial assistance, the Ministère du Travail, de l’Emploi et de la Solidarité sociale notifies the RAMQ, which registers the person for the Public Prescription Drug Insurance Plan. The person therefore has no steps to take.
When purchasing insured drugs, recipients of last-resort financial assistance must present their valid Health Insurance Card and their claim slip (carnet de réclamation).
Ceasing to be a recipient of last-resort financial assistance
When a person ceases to be a recipient of last-resort financial assistance, the Ministère du Travail, de l’Emploi et de la Solidarité sociale notifies the RAMQ, which cancels his or her public plan registration. The person must then take certain steps regarding his or her prescription drug insurance coverage.
The person first needs to determine whether he or she is eligible for a private plan. Eligibility is usually available through employment or through membership in a professional order or association to which the person belongs.
Eligibility for a private plan is also possible through one's spouse. 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 RAMQ.
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 or the RAMQ 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.