Quebec is different from most of Canada in one important way: prescription drug insurance is mandatory. Every person who is eligible for the Quebec health insurance plan must also be covered for prescription drugs, either through a private group plan or through the public prescription drug insurance plan administered by the Régie de l’assurance maladie du Québec (RAMQ).
Many people discover this rule only when they change jobs, retire, move to Quebec or start working for themselves. This guide explains how the system works, who must be covered by which plan, and what to check so you never end up without coverage.
The basic principle: everyone must be covered
Quebec’s prescription drug insurance system is a hybrid. Private insurers cover a large part of the population through group plans, mainly offered by employers and professional or union associations. The RAMQ public plan covers people who do not have access to such a plan.
The key point is that coverage is not optional. You are covered by one or the other, and the rules determine which one applies to you.
When you must join a private group plan
If you have access to a group insurance plan or an employee benefit plan that includes prescription drug coverage, for example through your employer, your professional order or an association, you are generally required to join it. This applies even if you would prefer the public plan.
You must also cover your spouse and your children under that plan, unless they already have access to a private plan of their own.
Who counts as a spouse?
For the purposes of the prescription drug insurance plan, spouses include married and civil union spouses, as well as de facto spouses who meet the conditions set by the rules, such as having lived together for a certain period or having a child together. The exact definition is detailed by the RAMQ, so check it if your situation is not clear.
What about children?
Children, and in some cases older dependants who are full-time students or have a functional impairment, are generally covered under a parent’s plan. The private plan must offer at least the minimum coverage required by law.
When the RAMQ public plan applies
You must register with the public prescription drug insurance plan if you do not have access to a private group plan. This is often the case for:
- Self-employed workers who do not belong to a group plan
- People working for an employer that does not offer drug coverage
- People without employment income who are not covered as a spouse or child under a private plan
- Most people aged 65 or over, who are automatically covered by the public plan, though some can choose to keep a private plan if one is available to them
Registration is not automatic for everyone under 65. If you lose access to a private plan, for example after losing your job, you must register with the RAMQ public plan within the required timeframe to avoid a gap.
How the public plan is paid for
People covered by the public plan pay a premium that is calculated when they file their Quebec income tax return. The amount depends on family income and may be reduced or zero in some situations. When you buy a covered medication, you also pay part of the cost at the pharmacy, through a deductible and coinsurance, up to a maximum. These amounts are adjusted periodically, so always check the current figures on the official site.
Official, up-to-date details are available on Québec.ca.
Life events that change your coverage
Your obligations can change at several points in your life. Each one is a good time to review your situation:
- Starting a new job: if the employer offers a group plan with drug coverage, you will usually have to join it.
- Losing or leaving a job: register with the RAMQ public plan if you no longer have access to a private plan.
- Becoming self-employed: check whether an association or professional order offers a group plan; otherwise, register with the public plan.
- Moving in with a partner: your partner’s private plan may now have to cover you.
- Having a child: add the child to your plan.
- Turning 65: review your options carefully, as rules specific to this age apply.
- Moving to Quebec: you must first be eligible for the Quebec health insurance plan.
How to shop and compare as a self-employed person
If you are self-employed in the Laurentides, you may be able to choose between joining a group plan offered by an association and staying with the public plan. When comparing:
- Look at the full cost, including premiums, deductibles and coinsurance
- Check which other benefits are bundled with the drug coverage, such as dental or paramedical care
- Read the conditions for adding a spouse and children
- Ask whether the plan can be cancelled or modified, and how
An independent broker can help you compare options. Our guide on choosing between an insurance broker, agent or direct insurer in Quebec explains how each works.
Related mandatory coverage in Quebec
Prescription drug insurance is just one of the forms of insurance that are mandatory in Quebec. For an overview, including auto insurance obligations, read What Insurance Is Mandatory in Quebec?. If you are setting up a new household, our guide on how to shop for home insurance in the Laurentides will also help.
FAQ: prescription drug insurance in Quebec
Is prescription drug insurance mandatory in Quebec?
Yes. Everyone eligible for the Quebec health insurance plan must be covered for prescription drugs, either by a private group plan or by the RAMQ public plan.
Can I choose the RAMQ public plan instead of my employer’s plan?
Generally no. If you have access to a private group plan with drug coverage, you must usually join it and cover your spouse and children who do not have their own private plan.
What happens if I lose my job?
If you no longer have access to a private group plan, you must register with the RAMQ public prescription drug insurance plan to stay covered.
How do I pay for the RAMQ public plan?
The premium is calculated when you file your Quebec income tax return, based on your family income. You also pay part of the cost of your prescriptions at the pharmacy, up to a maximum.
Am I automatically covered by the public plan at 65?
People aged 65 and over are generally covered automatically by the public plan, but those with access to a private plan may have choices to make. Review your situation before your 65th birthday.
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