If you form a new couple with another person, you may have to take steps regarding your health and drug insurance coverage or that of your spouse. If you are covered by the Health Insurance Plan, you must notify us of the change in your civil status.
Procedure concerning prescription drug coverage
Having a new spouse may affect your prescription drug coverage. Therefore, you have to check whether you are covered under the right plan.
You have to cover your spouse under your private plan, at least for the drug insurance portion. In this case, your spouse can no longer be covered by the public plan and must deregister from it. However, if your spouse is covered under another private plan, you don’t have to cover them.
Private plans are available through a person’s employment or professional association or order. Most of the time, prescription drug insurance is included as part of a plan covering other health care (i.e. a health insurance plan). Sometimes, this coverage is provided alone.
If you both qualify for each your own private plan, you can each join your respective plan or join the same plan. In this situation, you can choose the private plan that suits you best.
Neither of you may be covered by the public plan. If, by error, this is the case for one of you, then that person must deregister.
If you and your new spouse are covered by the public plan, you can both continue to be covered this way. However, you still have to notify us of your new civil status.
By order of priority, coverage of a child whose parents do not share the same residence is with the private plan of the parent with whom the child is living. If this parent is not eligible for a private plan, then the child is covered by the private plan of the other parent. Finally, if both parents are ineligible for a private plan, they must be registered with the public plan, which will cover the child.
If one of the parents becomes the spouse of someone who is eligible for a private plan, that parent must be covered under the private plan. The child of that parent will also have to be covered under the private plan, if he or she is living with the couple.
Your maximum annual contribution: Notifying a new insurer
You pay for your covered drugs until you reach a maximum amount: your maximum annual contribution. As a general rule, your insurer (private insurer or RAMQ) sees to it that this maximum is not exceeded. However, if you change insurance plans in the course of the year and believe that you will reach the maximum amount before the end of the year, you must inform your new insurer of the amount of your contributions.
If your new situation requires you or your children to move, refer to the Moving webpage to find out how to report a change of address.