Highlights
If you are a full-time employee or a part-time employee covered under the Comprehensive Health Plan, the following provisions apply. However, if you are a part-time employee covered under the RAMQ Drug Plan Equivalent, you are covered for the drugs listed on the RAMQ formulary; for more details, go to the government plan site.
Current coverage |
|
| Annual deductible | $60 per adult, maximum $120 per family |
| Percentage reimbursed subject to the deductible and certain limits: | |
| RAMQ drugs | 80% (or 100% once these annual eligible expenses, including eligible medical and paramedical expenses, exceed $2,000 per family in a benefit year)* |
| Medical and paramedical expenses (including paramedical practitioners) | 80% (or 100% once these annual eligible expenses, including the portion of any drugs paid by a provincial drug plan, exceed $2,000 per family in a benefit year)* |
| Psychologists and psychiatrists | 50% |
| Vision care (depending on your eligible employee group) | 80% |
| Percentage reimbursed NOT subject to the deductible but subject to certain limits: | |
| Non-RAMQ drugs | 50% |
| Emergency care and travel assistance outside your province of residence | 100% |
| Hospital care (semiprivate room in a public general hospital or a licensed convalescent hospital) | 100% |
| Maximum lifetime reimbursement |
|
| *Note: for each benefit year, the Plan provides that, once the combined expenses for RAMQ drugs and major medical services reaches $2,000 such expenses will be reimbursed at 100% for the rest of the benefit year. | |
This annual eligible expense maximun of $2,000 does not apply to:
- non-RAMQ drugs;
- vision care; and
- the services of psychologists and psychiatrists
Please refer to the Eligible expenses section for a list of various covered expenses under each type of service as well as the Exclusions and limitations section.
