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Normandin Beaudry

The eligibility and enrolment to the Régie de l'assurance maladie du Québec

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There, in black and white

NB Bulletin Vol. 4 N. 10, August 2001

The Régie de l´assurance maladie du Québec (RAMQ) has modified the criteria concerning the eligibility and enrolment to its medical and hospital plan. As of May 31¸ 2001¸ a waiting period of up to three months following enrolment to the plan is necessary for out of province citizens and foreign nationals establishing themselves in Quebec before being covered by the plan. These measures also apply to a spouse and any dependants who must also satisfy the criteria set by the RAMQ on eligibility and enrolment.

Canadian citizens coming from other provinces establishing themselves in Quebec

These citizens are presently covered under the plan established by their province of origin. This coverage will continue up until they are covered by the RAMQ plan.

Foreign nationals establishing themselves in Quebec

There are several exceptions that apply to those coming from abroad to reside in Quebec on a temporary or permanent basis. It is therefore preferable to verify with the RAMQ the eligibility conditions for each particular situation. Here are a few general situations for which guiding principles have been established.

In order to become eligible to the RAMQ plan¸ a foreign national who comes to work in Quebec on a temporary basis must have a working visa for a minimum period of six months. In which case¸ the three-month waiting period following enrolment to the RAMQ plan also applies. The same conditions apply to the worker´s spouse and any dependants.

However¸ the residents of the following countries are eligible to the plan¸ and this¸ without being affected by the three-month waiting period due to a reciprocal agreement with the province of Quebec: Denmark¸ Finland¸ France¸ Greece¸ Luxembourg¸ Norway¸ Portugal and Sweden.

In the situation where a person leaves his country of origin to reside in Quebec on a permanent basis¸ the reciprocal agreement between Quebec and the countries outlined above does not apply and the three-month waiting period will be enforced.

The impact on private group insurance plans

As a result of these modifications¸ newcomers arriving from outside the country will be required to pay for medical services or otherwise purchase private health insurance during the three-month waiting period. A company who intends to repatriate or to hire a person from outside the province of Quebec must pay particular attention to its group insurance plan. Indeed¸ the majority of group insurance plans in Canada are designed to provide coverage over and above that of the RAMQ plan or any other provincial plan. Consequently¸ an agreement could be reached with an insurer to provide¸ during the waiting period¸ the services normally covered by the RAMQ. Coverage could include expenses for the services of a medical doctor¸ surgical expenses and hospitalisation fees for a public room. Moreover¸ it is possible to cover these cases with certain individual insurance products available on the market.

 

Please feel free to contact us for additional information.

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