Understanding the limitations of public health insurance coverage

The Régie de l’assurance maladie du Québec (RAMQ) is the provincially run health insurance program for Québec residents. It provides you with access to emergency care and preventative health care free of charge.

While the program is available to all residents who have permanent residency in the province, there are some limitations. The plan provides coverage for basic care needs, but does not cover many forms of treatment, including dental care. For a full list of what is and is not covered under the RAMQ, visit Quebec’s Ministry of Health and Social Services Web site.

Eligibility limitations

To qualify for RAMQ coverage, the following criteria apply:

• You must be a Canadian citizen or permanent resident
• Your principal home must be in Québec
• You must be away from the province for less than 183 days per calendar year.

Most Quebecers qualify under these eligibility limitations. However, residents who are away from the province for an extended period of time may have to reapply for coverage.

Waiting period for new Québec residents

New residents are not automatically granted provincial health insurance coverage when they move to Québec. This waiting period may be as much as three months, during which health care is not covered.

Many Quebecers and new immigrants assume they will receive government health care when they move to the country, only to find out they have to wait to receive their permanent resident card. If you find yourself in this situation, the good news is that Blue Cross offers plans for visitors to Canada and for Canadian residents returning from a lengthy absence.

Other limitations

Whether you have lived in Québec your entire life, are a Canadian citizen, or a new immigrant to the province, there are limitations of your public health coverage that you need to be aware of. Because of these limitations, an increasing number of Quebecers are opting for supplementary health insurance to help them cover the additional costs.

Here are some of the limitations:

• Not all prescription drugs are covered
• Services from a podiatrist are only partially covered
• Dental care is not covered
• Services offered by other health care providers, such as physiotherapists, chiropractors, massage therapists, and other practitioners are not covered
• Eye care exams are not covered.

Learn more about costs not covered by the RAMQ.

For more information about these limitations, contact the Régie de l’assurance maladie du Québec (RAMQ).