Know the eligibility conditions for the public plan

What is prescription drug insurance?

• Prescription drug insurance is compulsory for any person living in Québec on a permanent basis.
• Two types of plans provide this coverage: private plans and the public plan. RAMQ administers the public portion of the prescription drug insurance while insurance companies offer private plans.
• The public plan covers around 8,000 prescription drugs.
• In general, if you are eligible for a private plan, you are obliged to join it and provide coverage under this plan for your spouse and children. Otherwise, you must register for the public plan.
• Eligibility for prescription drug insurance depends on your eligibility for health insurance.

Eligibility conditions for the public plan, in brief

You are generally eligible for Public Prescription Drug Insurance Plan if:

• You do not have access to a private plan
• You are age 65 and over and have not joined a private plan
• You are a recipient of a financial assistance program with claim slip (carnet de réclamation)
• You are a person under age 18 living in Québec and your parents do not have access to a private plan
• You are a person under age 18 temporarily living in Québec for more than 6 months

Do you want to register for or deregister with the Public Prescription Drug Insurance Plan? Do you want to check whether you are eligible? Answer a few questions in our Register for or deregister with the Public Prescription Drug Insurance Plan online service to find out which procedure is right for you.

Persons eligible for a private plan

You are under age 65 and have access to a private plan? You must join it 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 employer or professional group: union, association or order
• Through your spouse
• Through your parents (for children or dependants)

Persons ineligible for the public plan or private plans

Temporary Québec residents age 18 and older are not eligible for the public plan. However, they can take out private insurance if they wish.

Certain permanent Québec residents cannot obtain coverage under the public plan or a private plan because they have access to insurance otherwise.

Differences between the public plan and private plans

Public plan

• Costs covered by RAMQ
• You have to register with the public plan if you do not have access to a private plan

Private plans

• Costs covered by insurers or the administrators of uninsured employee benefit plans
• You have to join a private plan if you have access to one
• Plans offered by employers or professional groups

For more information on private plans and the responsibilities of their administrators, refer to the webpage Information on private plans.

Private plans or public plan when I turn 65?

When you turn 65, your registration with the Public Prescription Drug Insurance Plan is automatic. No action is required on your part. However, 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) and a private plan (supplemental coverage)

To find out more, refer to the Turning 65 webpage.

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 compulsory basic coverage of the public plan; it only adds to it. Basic coverage includes prescription drugs covered by the public plan, namely those on the List of Medications and those covered exceptionally for serious medical conditions.

Consequences if you do not meet your obligations

Question	Answer
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.