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Normandin Beaudry

New financial parameters for the Quebec prescription drug insurance plan

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There, in black and white

NB Bulletin Vol. 20 N. 12, July 2017

On July 1 each year, the Régie de l’assurance maladie du Québec adjusts the financial parameters applicable to the public prescription drug insurance plan to take into account the increase or decrease in plan costs.

The table below presents the changes that will apply to all individuals covered under the public plan, with the exception of:

  • Individuals who receive prescription drugs free of charge (no premium or contribution):
    • holders of a claim slip (generally recipients of last-resort financial assistance)
    • individuals aged 65 or over receiving from 94% to 100% of the Guaranteed Income Supplement (GIS)
    • children under 18
    • full-time students aged 18 to 25 who do not have a spouse and live with their parents
  • Individuals aged 65 or over receiving less than 94% of the GIS who are subject to a reduced contribution.

As last year, all financial parameters also increase this year.

We would like to remind you that:

  • The annual premium is the amount paid by an adult when income tax returns are filed in order to be covered by the public plan.
  • The deductible is a fixed amount that constitutes the first portion of the cost that an adult must pay when purchasing insured drugs.
  • The copayment is the portion of the drug costs that an adult must pay once he has paid the deductible. In other words, when a person's drug costs exceed the deductible, the person pays a portion of the remainder.
  • The maximum contribution is the maximum annual amount that an adult is required to pay per month and per year to obtain drugs covered by the the public plan. This maximum amount includes the deductible and the copayment.

Impact on private group insurance plan costs

Because private group insurance plans do not typically apply the same parameters or the same set of cost control measures as the public plan, we do not anticipate significant financial impact on private plans. Plans that apply the same parameters as those used by Quebec's public drug plan could benefit from a slight cost reduction.

 

Please feel free to contact us for additional information.

514.285.1122
 
630, René-Lévesque Blvd. West, 30th floor
Montreal, Quebec, H3B 1S6