Find out about the services covered by the RAMQ and see the procedure for contesting fees.
Anyone who lives in Quebec is covered by the Régie de l’assurance maladie du Québec (RAMQ). If you have a health insurance card, you can receive medical care covered by the RAMQ free of charge.
Some services are not insured by the RAMQ. In this case, these services may be billed by the physician.
Here are a few examples.
- Photocopying costs;
- The cost of purchasing an intrauterine device;
- Vaccines administered at the physician’s office.
The Regulation abolishing accessory costs related to the provision of insured services and governing transportation costs for biological samples came into force on January 26, 2017. This regulation abolishes all incidental fees or “accessory costs” related to the provision of insured services, with the exception of fees for the transportation of biological samples.
A fee may be charged to an insured person for the transportation of biological samples collected at a private health facility or a specialized medical centre, since these fees are not covered by the RAMQ.
- A maximum of $15 can be charged to the patient for the transportation of a blood sample.
- A maximum of $5 can be charged for the transportation any other biological sample.
- These fees may only be charged once when more than one sample is transported to a given laboratory.
Posting of fees
The Health Insurance Act stipulates that :
- A physician “must post in public view [...] the tariff of fees that the physician may charge an insured person [...] and the tariff of fees for medical services rendered by the physician that are non-insured services”.
To find out more about the services covered and fees charged, go to the RAMQ website.
The Code of ethics of physicians stipulates that :
- The physician must display, for public view, in the waiting room of the place where he practices the price of any uninsured services, supplies and medical care that he charges for.
- The physician must also provide an itemized invoice that shows the fee charged for each service.
Private medicine and services that are not covered
The fees charged may vary, both for services that are not covered and in the event that the physician does not participate in the health insurance plan.
Physicians may charge patients for services using their own fee schedule. However, they must inform the patient of the nature and scope of the services included for the fee. They must clearly indicate the cost of fees and the price of medical supplies, devices and medications. The patient must therefore evaluate the proposed rates, whether for services offered in plastic surgery, orthopedics, ophthalmology or any other sector of activity. They must be vigilant, just as they would be when purchasing a good or any other professional service.
Anyone who feels they have been wronged and would like to contest the fees charged by their physician may obtain information from the CMQ’s Syndic and request a conciliation of accounts.
A conciliation of accounts may, for instance, be requested in relation to fees for uninsured services or for care provided by physicians who do not participate in the health insurance plan.
If a patient paid sums of money to a physician, such as a fee advance, and these sums were used by the physician for purposes other than those intended, they may file a claim for compensation.