Know the eligibility conditions for the public plan
If you are living in Québec on a permanent basis, you must have prescription drug insurance coverage at all times. Generally, you are eligible for the Public Prescription Drug Insurance Plan administered by RAMQ if you do not have access to a private plan.
Who is eligible for the public plan
The following persons are eligible for the Public Prescription Drug Insurance Plan:
- Persons without access to a private plan
- Persons age 65 and over who have not joined a private plan
- Recipients of last-resort financial assistance and certain other holders of claim slips (carnet de réclamation)
Who is eligible for a private plan
You must join a private plan if you have access to one and are under age 65 (at least for prescription drug coverage). You must also provide coverage under this plan for your children and spouse, if they are not already covered by a private plan. You can access a private plan in the following ways:
- Through your employment or profession (via your employer or professional group: union, association or order)
- Through your spouse
- Through your parents, if you are a child or student
Who is ineligible for the public plan or a private plan
In most cases, temporary Québec residents are not eligible for the public plan or a private prescription drug insurance plan. However, they may obtain other insurance.
In addition, certain permanent Québec residents cannot obtain coverage under the public plan or a private plan because they are insured under another statute or program:
- Beneficiaries of the James Bay and Northern Quebec Agreement (Cree and Inuit) and the Northeastern Quebec Agreement (Naskapi)
- Indians registered with Crown-Indigenous Relations and Northern Affairs Canada and Inuit recognized by this ministry
- Persons accommodated in a public or private facility under agreement operating a residential and long-term care centre
Differences between private plans and the public plan
Both types of plans cover your spouse and children. However, there are some différences.
- Costs covered by insurers or the administrators of uninsured employee benefit plans
- Plans offered by employers or professional groups
- You have to join a private plan if you have access to one
- Costs covered by RAMQ
- You have to register with the public plan if you do not have access to a private plan
For more information on private plans and the responsibilities of their administrators, refer to the webpage Information on private plans.
Consequences if you do not meet your obligations
|You don’t have any prescription drug insurance coverage?||You will have to pay Revenu Québec an amount equivalent to the public plan premium for each full month during which you had no coverage at all.|
|You are registered with the public plan even though you are eligible for a private plan?||You will have to repay the cost of the prescription drugs paid by RAMQ during the time when you had access to a private plan.|
Private plan or public plan when I turn 65?
When you turn 65, you will automatically be registered with the Public Prescription Drug Insurance Plan. On the other hand, if you qualify for a private plan, you will have a choice to make. You can choose to be covered:
- Only by the public plan
- Only by a private plan offering at least basic coverage
- By both plans: Public plan (basic coverage) et a private plan (supplemental coverage)
To find out more, refer to the webpage Turning 65.
Supplemental private coverage
You must be registered with the Public Prescription Drug Insurance Plan if your private plan provides supplemental coverage only. This is because supplemental coverage does not replace the mandatory basic coverage of the public plan; it only adds to it.
Application for review
You can apply for an administrative review if you disagree with a RAMQ decision. To find out more, refer to the page Request a review of a decision.