You have to check your prescription drug insurance coverage if you are unemployed or temporarily absent from work. Everyone who has taken up residence in Québec has to be covered at all times.
You will need to find a new insurer if your prescription drug coverage was provided under your former employer’s private plan. Ask yourself the following questions:
As a rule, you cease to be covered on the official date your employment ends. Check with the insurer. Also, find out the reimbursement terms and conditions for the expenses you might incur before this date.
You may have access to one, for instance, through:
If so, you have to join that plan. Otherwise, you have to register with the Public Prescription Drug Insurance Plan.
Usually, you remain covered under your prescription drug plan during a temporary leave. This applies to all situations where the employment relationship with the employer is maintained during your absence:
You remain covered by the public plan during a temporary absence from work, provided that you are registered. No steps need to be taken.
Certain absences do not change your participation in your private plan. By paying the premium set out in the insurance contract, you remain covered in the following situations:
In other situations, check your insurance contract to find out whether you remain insured under your private plan. This is necessary in the following situations:
If your private insurance is maintained during your absence, you have to remain insured by your private plan and pay the premiums.
If your private insurance is not maintained, your insurance ends. You must then check whether you qualify for a private plan in another way. If you do not have access to a private plan, you will have to register with the public plan. To find out more, refer to the webpage Know the eligibility conditions for the public plan.
If you change insurers in the course of the year, you must avoid overpaying your annual maximum contribution for the purchase of covered prescription drugs.
Your former insurer must give you the Statement of Contributions, which includes:
Certain insurers will provide this document automatically, while others will do so only on request. You have 6 months following the date the change was made to request the statement of contributions from your former insurer. You must then provide this document to your new insurer, which will be able to take it into account in making sure your maximum contribution is not exceeded. To facilitate processing of your application, send the statement of contributions rather than any other document.
To find out more about the annual maximum amount payable and the contribution itself, refer to the Rates in effect and Amount to pay for prescription drugs webpages.
