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Know the eligibility conditions for health insurance

To qualify for the Québec Health Insurance Plan and remain eligible, you have to meet the eligibility conditions that correspond to your status with RAMQ. If you are eligible, you will receive a Health Insurance card that gives you access free of charge to health care and services covered and paid for by RAMQ.

Health insurance in brief

  • To benefit from covered health care free of charge, you must present your valid Health Insurance Card each time you receive covered health care in a health facility (CLSC, hospital, medical office, clinic, etc.).
  • To remain eligible for health insurance, you must comply with the Presence in Québec rule. These rules vary depending on your status (person settled or temporary staying in Québec).

Ineligible? You can still access health care and services, but you have to pay for them.

Are you looking for information on prescription drug insurance? Refer to the Know the eligibility conditions for prescription drug insurance webpage.

What is your status with RAMQ?

To determine your eligibility for health insurance, we first need to know your status. Depending on your situation, we consider you to be:

  • A person settled in Québec
  • A person temporarily staying in Québec

Your status may change over time, depending on the immigration documents you hold.

Birth in Québec

A person born in Québec is automatically eligible and registered for health insurance if their parents were eligible at the time of their birth: no action is required on their part. To find out more on the eligibility of children, refer to the Birth or adoption webpage.

Person settled in Québec

We consider you a person settled in Québec if you meet the following 3 conditions:

  • Have your main residence in Québec
  • Comply with the Presence in Québec rule: be present in Québec 183 days or more per calendar year
  • Have authorization to remain in Canada, that is, hold one of the following statuses:

To remain eligible for health insurance, you must not be absent from Québec 183 days or more, consecutive or not, in a given calendar year (January 1 to December 31). The departure and return dates, as well as absences of 21 consecutive days or less are not tallied. If you do not comply with this rule, you no longer have the status of a person settled in Québec. You will then lose your eligibility for the entire year of your absence, and you will have to reimburse the covered services received during the year. Please note that we may ask you for proof of your presence in Québec.

Planning a long trip? To help you determine whether you remain eligible for health insurance during your absence, use the Absence from Québec calculation tool.

Exceptions for persons settled in Québec

In certain situations, you may remain eligible despite a total annual absence of 183 days or more. Contact us to check whether you qualify for one of the exceptions to the presence rules.

Person temporarily staying in Québec

We consider you a person temporarily staying in Québec if you meet the following 2 conditions:

  • Comply with the Presence in Québec rule: not be absent from Québec for more than 21 consecutive days
  • Have authorization of stay in Québec, that is, hold one of the following immigration statuses:
    • Holder of a study or internship permit from a country that has signed a social security agreement with Québec
    • Recipient of a fellowship to study or internship from the Ministère de l’Éducation du Québec
    • Head of a liturgical office in Québec holding an authorization of stay valid for more than 6 months
    • Canadian citizen in Québec to carry out a work contract for a determined period of more than 6 months
    • Child under age 18 in Québec for more than 6&nbs;months
    • Spouse or dependant age 18 to 25 who holds an authorization of stay of more than 6 months accompanying an adult falling into one of the above categories

Worker from another Canadian province or territory

Are you a Canadian citizen or permanent resident coming to Québec to work temporarily for 12 months or less? You remain covered under the plan in your home province or territory. Contact the organization responsible for the health insurance plan in your province or territory to inform them of your temporary stay in Québec. You can also find out more about the procedure to follow depending on your situation.

If the duration of your work contract is more than 12 months, you have the status of a person settling in Québec. Therefore, you must register for health insurance.

If you are in Québec to pursue work, studies or internship, you must comply with the Presence in Québec rule that applies to temporary stays. You must therefore remain in Québec for the entire duration of your stay, except for absences of 21 consecutive days or less.

Persons ineligible for health insurance

If you do not meet the conditions for persons settled or temporarily staying in Québec, you are unable to register for health insurance. This is the case if you are travelling to Québec for a period of 6 months or less. The same conditions apply to accompanying persons (spouse or dependant). To remain in Québec for more than 6 months, you must hold a valid authorization of stay.

Important: we strongly advise you to take out travel insurance before visiting Québec. A day in hospital can cost more than $3,000, in addition to doctors’ fees. If you receive health care during your visit to Québec, you will have to reimburse it.

  • Tourists (with or without Canadian citizenship)
  • Student from a country that has not signed a social security agreement with Québec
  • Person holding an authorization of stay of less than 6 months (with some exceptions)
  • Person holding an open work permit (with some exceptions)
  • Canadian citizen coming to work for less than 6 months
  • Person who has applied for refugee status in Canada (you may benefit from coverage under the Interim Federal Health Program)
  • A person age 18 to 25 accompanying a parent who is staying in Canada and who is not a full-time student

When does your coverage starts?

Persons arriving from another country

When you register for health insurance, your coverage usually begins after a maximum of 3 months. This is known as the “waiting period”. This waiting period applies even if you are a Canadian citizen, but does not apply to children under age 18.

Since we do not reimburse health care and services received during this period, we strongly recommend that you take out private insurance as soon as you arrive in Québec. To find out more about insurance, consult the Ombudsman for Life and Health Insurance.

Certain health care and services are free of charge during the waiting period. This applies only to those:

  • needed by victims of conjugal or domestic violence or of sexual assault
  • related to pregnancy, child birth or termination of pregnancy
  • needed by people suffering from infectious diseases that have an impact on public health

You can benefit from an exception and be entitled to health insurance as soon as you register in the following situations:

  • You are arriving from a country that has signed a social security agreement with Québec
  • You are a refugee or protected person in Canada
  • You are a Canadian repatriated by the government
  • You are a recipient of last-resort financial assistance
  • You are a fellowship recipient from the Ministère de l’Éducation or the Ministère de l’Enseignement supérieur
  • You are working in Québec under the Seasonal Agricultural Worker Program (SAWP) or the Temporary Foreign Worker Program (TFW)

Persons arriving from another Canadian province or territory

When you register for health insurance, your coverage usually begins after a maximum of 3 months. During this period, you remain covered under the health insurance plan in your home province or territory. The health care covered is then paid for by your home province or territory under interprovincial agreements.

Presentation of a valid Health Insurance Card

You must present your valid Health Insurance Card when you receive covered health care or services. Otherwise, you must pay for them. Depending on your situation, you may need to register for health insurance or renew your card. Refer to the Obtain a new health insurance card webpage to find out more.

Did you pay for covered services?

If you have paid for covered health care, you can request a reimbursement. Here is how to proceed, depending on the situation:

  • You were unable to present your card, but it is valid: you can request a reimbursement for the health care or services covered that you had to pay for.
  • Your Health Insurance Card was expired when you received treatment: if you are still eligible for health insurance, you must first renew your Health Insurance Card. You can then request a reimbursement for the health care or services received.