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The Program for Devices That Compensate for a Physical Deficiency is intended for persons covered by the Québec Health Insurance Plan who have a motor deficiency. 

To find out more, refer to the page Devices that compensate for a physical deficiency.

This form is used to apply for a reimbursement of the cost of supplies purchased from a provider that has not signed an agreement with RAMQ. Must be accompanied by the original invoices and proofs of payment, as well as a medical prescription in the case of a first application.

To find out more about the procedure, refer to the page Compression garments for lymphedema.

Note: You must save the claim form on your computer and open it with Adobe Acrobat Reader software.

Form 4258

This form is used to request a reduction in the financial contribution amount required for an adult being accommodated in a public health facility. For instructions for completing the form, use the Guide to the Application for Exemption or for Re-evaluation.

Form 4473

This list was published on June 23, 2021.