Covered pharmacy services
Several services are available at pharmacies. Some are covered free of charge by the Health Insurance Plan. You may also benefit from other services that are covered by your insurer, whether it is the Public Prescription Drug Insurance Plan or a private plan.
Prescription drug insurance covers several pharmacy services under the Regulation respecting the basic prescription drug insurance plan. Still, your insurer may require that you pay a contribution (deductible and co-insurance) for these services, as would be the case with covered prescription drugs. To find out more, refer to the page Amount to pay for prescription drugs.
Covered service without cost
Several pharmacy services are covered at no cost by your insurer (private or public) or simply by presenting your Health Insurance Card:
- Administration of a drug to demonstrate its appropriate use
- Administration of certain drugs in an emergency situation
- Adjustment of a prescription in order to attain therapeutic targets
- Initiating a drug therapy (including emergency oral contraception)
- Consultation request from another health professional
- Modification of a drug therapy
- Prescription of a drug
- Case management after hospitalization
- Case management of clientele receiving palliative care
- Assessment to extend a prescription and its extension
- Therapeutic substitution of a drug
- Vaccination at a pharmacy in accordance with the conditions of the Québec Immunization Program
Vaccination provided under the Québec Immunization Program
Vaccinations done under the Québec Immunization Program are covered at no cost by the Québec Health Insurance Plan. This allows pharmacists to prescribe and administer program-covered vaccines to anyone age 6 or over. In the context of the current pandemic, only the influenza vaccine administered at a pharmacy is covered for children under age 6, in accordance with the eligibility criteria of the Flu Vaccination Program.
A nurse employed by a pharmacy may also administer vaccines.
Billing of a vaccine not covered by the Québec Immunization Program
At a pharmacy, you may be billed for both the injection and the vaccine, if the vaccine is not covered under the program.
Furthermore, travel vaccinations are not covered, neither the injection nor the vaccine itself, regardless of where it is provided. You will be billed for this service.
Conditions for access to covered services
You have to present your valid Health Insurance Card to receive covered services. Otherwise, you will have to pay the total cost of the services rendered and then apply for a reimbursement. If you are a recipient of last-resort financial assistance, you must also present your valid claim slip (carnet de réclamation).
All covered pharmacy services are free of charge if you are entitled to free services under the Public Prescription Drug Insurance Plan. To find out more, refer to the page Rates in effect.
Depending on your situation, you may have to present your valid Health Insurance Card, in addition to your private plan insurance card, to the pharmacist to receive covered services. Inquire with your insurer to find out the reimbursement procedure.
Certain pharmacy services are not covered, and you will have to pay for them. Here are some examples:
- Placing drugs in a pill organizer at your request, if not medically justified
- Sample taking by a nurse at a pharmacy (e.g. blood test)
- Group A Strep-test
- Travel vaccination