New financial parameters for Quebec’s prescription drug insurance plan

Every July 1, the Régie de l’assurance maladie du Québec adjusts the public prescription drug insurance plan’s financial parameters 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 ages 65 or older receiving 94% to 100% of the Guaranteed Income Supplement (GIS);
  • children under 18;
  • full-time students ages 18 to 25 who do not have a spouse and live with their parents.
• Individuals ages 65 or older receiving less than 94% of the GIS who are subject to a reduced contribution.

This is only the second time that the annual premium has decreased since the plan was introduced in 1997. Copayment continues to inch higher with a 0.1% increase, an uncommon practice in private plans where copayments generally remain steady year to year and do not include a decimal.

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 covered drugs.
• The copayment is the portion of the drug costs in excess of the deductible that an adult must pay.
• The maximum contribution is the maximum amount that an adult is required to pay per month and per year to obtain drugs covered by the public plan. This contribution includes the deductible and the copayment.

Because private group insurance plans do not typically apply the same parameters or set of cost control measures as the public plan, we do not anticipate a 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.

For additional information, feel free to contact Normandin Beaudry’s consultants.