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Health Coverage Choice & RAMQ

Frequently asked questions for Quebec residents

What is RAMQ and why do I need it?

  • RAMQ (Régie de l’assurance maladie du Québec) is the mandatory government health insurance system in Quebec.
  • It provides residents of Quebec with basic health coverage (prescription drugs) if they are not covered by an eligible group plan.
  • If you are currently without coverage through an eligible group plan (e.g., workplace plan or spouse’s plan) the Quebec government requires that you enrol for coverage with RAMQ.

What is Health Coverage Choice (HCC) and why do I need it as well as RAMQ?

  • HCC is Sun Life’s extended health and dental care coverage available to those who have lost coverage1 through their workplace or retiree group plan.
  • HCC provides more comprehensive coverage for healthcare costs not covered by RAMQ, such as a hospital room, private nursing, out-of-province/country medical coverage and paramedical services, as well as expanded coverage for prescription drugs and vision care.
  • HCC does not qualify as an eligible group plan, therefore HCC coverage applies over and above RAMQ coverage. HCC is the second payor after the claim has first been submitted to RAMQ.
  • Because of the requirement in Quebec to enrol in RAMQ, Sun Life has adjusted the premiums for Quebec residents. In many cases the combined cost of HCC and RAMQ is the same or less than the HCC premiums in all other provinces.

Example:

This example is to illustrate how Health Coverage Choice works with RAMQ for a $60 prescription2:

RAMQ

  • Coverage: 68% on full amount, less deductible
  • Deductible: $16.25
  • You pay: $30

RAMQ + HCC

  • Coverage: 80% on balance (after RAMQ)
  • Deductible: n/a
  • You pay: $6

You save: $24

RAMQ

  • Coverage: 68% on full amount
  • Deductible: n/a
  • You pay: $19

RAMQ + HCC

  • Coverage: 80% on balance (after RAMQ)
  • Deductible: n/a
  • You pay: $4

You save: $15

A Health Coverage Choice member saves $24 on the first prescription of the month, and $15 on all subsequent prescriptions that same month.

RAMQ percentages and deductibles are found at www.ramq.gouv.qc.ca.

How do I enrol?

  • RAMQ enrolment can be completed in person, online or over the phone. Details and requirements can be found at www.ramq.gouv.qc.ca.
  • You can enrol1 in a Health Coverage Choice plan today by calling 1-877-893-9893 and speaking with one of our licensed Financial Security Advisors.

Footnotes

1 If you’re under age 75 and it’s within 60 days of leaving your workplace or retiree group plan, you may be eligible.

2 Figures are rounded to the nearest dollar.