Benefits and cost of private drug insurance in Quebec.

Everybody living in Quebec permanently needs prescription drug insurance.  It is a type of insurance that is given by the RAMQ as a public plan which is fairly limited in coverage.

Another option for coverage is through private insurance companies that offer prescription drug insurance through group insurance plans or employee benefits.

How much does private drug insurance cost and what are its advantages?

While private insurance is more expensive than what is offered by the RAMQ, you can obtain many benefits.

Read on to know more about drug insurance in Quebec. You can also fill out the short online form on this page to receive FREE and NO-OBLIGATION quotes.

What is private drug insurance?

Private drug insurance from group insurance.

Private drug insurance is provided through group insurance or a corporate benefits program.

This insurance covers the cost of prescription drugs you purchase from a pharmacy.  The insurance plan is managed by a private insurance company and not by the government.

If you don’t have access to private drug insurance through your employer, you are automatically covered by the RAMQ public drug insurance in Quebec.

As a rule, you can get Public Prescription Drug Insurance coverage with the RAMQ.  However, if you have access to a private plan through your employer, you and your family (spouse and children) must apply for coverage.

How do I get private drug insurance in Quebec?

Private drug insurance is usually offered through group insurance that is available for employers and professional organizations. 

If your employer does not provide group insurance, you may be available to get coverage from your spouse’s company, or even that of your parents.

Here are some examples where you can get private drug insurance:

  • Through your job, if your employer offers a private plan;
  • Through a union, association or professional organization of which you are a member;
  • Through your spouse if the employer offers group insurance;
  • Through your parents if they have group insurance coverage.

Some insurers offer individual health insurance products. Our partner brokers can help you look for other insurance options and their prices if you don’t have access to a group insurance plan.

The minimum standards of coverage for private drug insurance

When you take out private drug insurance, you will want to get protection beyond what the basic public plan from RAMQ offers.

In fact, all private plans are required to offer basic drug coverage that is equal to RAMQ with additional protections and features. 

For example, additional services may include: dental care, vision care, physiotherapy, chiropractor, and more.

List of prescription drugs that must be covered

Insurance companies must cover a certain number of drugs which are also covered by the public plan. You can view the full list of drugs covered from this list as of August 2022 issued by the RAMQ.

How does private drug insurance premium payment work?

When do you have to pay for your private drug insurance?

Unlike the public plan where this is generally done when you file your income tax return, the private drug insurance premium must be deducted from your salary.

The Act relating to prescription drug insurance requires employers in Quebec to automatically deduct the private drug insurance premium from the salary of each insured person. If you are on your spouse’s insurance, the full amount of the premium will be deducted from their pay.

Reimbursement of drugs from insurance – Deductible and co-insurance

Regarding the reimbursement of prescription medications and the amounts of coverage, there are 2 important concepts to understand. 

These are the deductible and the co-insurance factor which determine the amounts of reimbursement to which you will be entitled when making a claim. 

Are you familiar with these concepts? Here is a brief explanation for each.

The deductible for Private Drug Insurance

The deductible is a fixed amount that you must pay out of your own pocket before the insurer pays your claim. The amount of the deductible is variable and changes from one private plan to another. For example, it can be $50, $250, $500 or even more sometimes. The higher the deductible, the cheaper the premium.

Private drug insurance coinsurance

The co-insurance factor is the percentage of the drug price that the insurer agrees to pay in the event of a claim. It applies once the deductible is paid. Some plans offer 60% reimbursement, while others offer 70-80%. The best ones will cover 95-100% of the cost of medications.

Concepts important to private drug insurance.

3 methods of reimbursement by the insurer for drug insurance

How does the reimbursement of your medications work when you are covered by private drug insurance in Quebec?

It all depends on the insurer you are dealing with. There are 3 common methods of reimbursement, and it is important to know which one applies to your situation in order to properly manage your claims.

Automatically upon purchase

When you pay for your medication over the counter, the pharmacy sees in your file that you are insured and automatically calculates the amount paid by the insurer, and the balance you must pay.

After the purchase without procedure

You pay for your medication out of pocket at the counter and receive a reimbursement from your insurer without having to do anything. Everything is done automatically.

After purchase with procedure

You pay for your medication in out of pocket at the counter. You must notify your insurer and provide proof of purchase. Reimbursement will then be initiated by the insurer.

What is the cost of private drug insurance in Quebec?

How much does private drug insurance cost in Quebec? This is the question that all customers are interested in. 

Pricing for individual drug insurance starts at around $28-30 per month, but depending on your client profile and the type of coverage you choose, prices can quickly rise above the $100 per month mark.

The best way to find the best drug insurance price is to have a broker look around for the best plan for you. This service is free and non-binding and is available to everyone.

Find drug insurance coverage with help from a broker.

Private drug insurance prices: $30-100/month

  • Insurance #1: $35/month
  • Insurance #2: $57/month
  • Insurance #3: $61/month
  • Insurance #4: $95/month
  • Insurance #5: $140/month

Are you eligible for private drug insurance?

Are you employed by a company that offers group insurance including private drug insurance?

If you have just recently started working for this company, you may not be eligible for this insurance.

Every company or organization has a set of criteria for eligibility for its group insurance plan. Here are some examples:

  • Not eligible for the plan during the 3-month probationary period;
  • Not eligible for the plan if the employee does not work a minimum number of hours per week;
  • Not eligible for part-time, contractual, retired, etc. employees.

Although your employer may control eligibility for the group insurance plan depending on your employment status, there are several other reasons that cannot be invoked.

You CANNOT be refused due to...

It is illegal for an insurer or an employer to refuse coverage under a group plan because of a risk related to age, sex, or state of health. The premium can be adjusted, but an outright denial cannot be issued for any of these reasons.

Choose the most advantageous private drug insurance

Choose the best coverage for private drug insurance.

Do you have access to a private drug insurance plan with your employer as well as your spouse’s employer?

This means that you have access to several private plans as you can subscribe to your company’s plan and your spouse’s plan.

Under this type of situation, you are not required to take out insurance from your employer if your spouse’s plan is better or more advantageous.

You can determine which plan works better for you and you and your spouse can both be covered by it. 

If you join your spouse’s insurance, you will simply have to provide proof to your employer that you are insured under another private plan.

Compare free quotes for private drug insurance

Compare free quotes for private drug insurance.

Are you out of luck because you have no private drug insurance plan or have no access to group insurance?

There may be other solutions for you. Our partner brokers can introduce you to individual insurance products and help you find the best options, free of charge.

Just fill out the form on this page to get connected with one of our partner brokers. 

You can also compare prices for dental insurance and other types of coverage that you are interested in.

Take advantage of our free telephone consultation to find the right private insurance that suits you at the soonest possible time.

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