What is the Quebec Prescription Drug Insurance Plan?

In Québec, everyone must be covered by prescription drug insurance. Two types of insurance plans offer this coverage:

  • Private plans (group insurance or employee benefit plans)
  • The public plan, that is, the one administered by the Régie de l’assurance maladie du Québec.

If you are eligible for a private plan, you must join that plan and provide coverage for your spouse and children. Only those persons who are not eligible for a private plan must register for the Public Prescription Drug Insurance Plan.

Administered by the Régie de l’assurance maladie du Québec, the Public Prescription Drug Insurance Plan is a government insurance plan offering basic prescription drug coverage. It was set up in 1997 to cover all Quebecers who are not eligible for a private plan.

The insurance plan helps cover a portion of the cost of prescription drugs purchased at the pharmacy. Below is an example:

EXAMPLE
A $60 prescription presented at the pharmacy on July 1, 2011

Monthly deductible

Monthly
co-insurance

Contribution paid by the insured person

Amount paid by the Régie

Fixed amount paid when making the first drug purchase during the month. 32% of the cost of the prescription minus the deductible Total of the deductible plus the co-insurance Cost of the prescription minus the contribution by the insured person

$16

$60 – $16
=
$44 x 32 %
=
$14.08
$16
+
$14.08
=
$30.08
$60
-
$30.08
=
$29.92

Generally speaking, persons covered by the public plan must pay a premium, whether or not they purchase prescription drugs. The premium is collected every year by the ministère du Revenu du Québec when income tax returns are filed. For example, the premium for 2011 will be collected in the spring 2012, when income tax returns for the 2011 taxation year are filed. Persons who pay a premium to the public plan must complete Schedule K of their Québec income tax return.

The amount of the annual premium varies from $0 to $563 per adult, depending on net family income. This amount is in effect from July 1, 2011 to June 30, 2012.

Source – Regie de l’assurance maladie Quebec:   http://www.ramq.gouv.qc.ca

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