Quebec amends basic drug plan

#181

PDF version

Quebec announced some changes to the parameters of the basic drug plan administered by the Régie de l’assurance maladie du Québec (RAMQ). Effective July 1, 2009, the following changes will affect plan sponsors who provide drug coverage to Quebec plan members.

 

 Legislative change

 Drug claims for your Quebec plan members

Increase in annual out-of-pocket maximum to $954 from $927

  • Drug claims from your Quebec plan members will now be subject to the new out-of-pocket maximum of $954.

 

Reduction in co-insurance (amount RAMQ pays) to 68% from 69%.

  • Drug claims that were previously paid at 69% to comply with RAMQ’s minimum requirements will now be paid at 68%.
  • If your plan supplements RAMQ coverage for plan members age 65 and over, you can expect a slight increase in claim costs for these members because the portion reimbursed by RAMQ will decrease by 1%.

RAMQ has also announced that the amount covered under the smoking cessation program will remain unchanged at $650.

We’re in the process of updating our systems to reflect these changes. There will be no immediate rate adjustments due to these changes and we expect that the impact on claim experience will be minimal.

Please share this information with your plan members as you see necessary.

Questions?

If you have questions, please contact your Customer Service Administrator at 1-877-786-7227