Quebec RAMQ out-of-pocket maximum increases

Plan sponsors with plan members who reside in Quebec must offer prescription drug coverage that meets the minimum legislative requirements set by the Régie de l’assurance maladie du Québec (RAMQ).

On July 1, 2016, the following changes were applied to private plans as announced by RAMQ :

  • The maximum annual out-of-pocket drug expenses that plan members are required to pay increased from  $1,029 to $1,046.
  • The plan member’s co-insurance level (maximum out-of-pocket expenses) increased from 34% to 34.5% of the prescription cost.

Quebec smoking cessation limits will not increase in 2017

The maximum coverage of $700 for Quebec smoking cessation products will not increase in January 2017.

Quebec's drug plan legislation requires that private drug plans are at a minimum  equal to the drug coverage provided by the RAMQ. As such, all drug plans covering Quebec plan members must provide coverage for smoking cessation products that are listed on the RAMQ Formulary.

Manulife will not automatically update applicable contracts to reflect the RAMQ July 1 out-of-pocket expense increases. If your contract duplicates coverage provided by RAMQ, and your contract reads that your annual out-of-pocket expenses are $1,029, you must submit an amendment to your account executive requesting that your contract be updated to match RAMQ's 2016-2017 minimum requirements.

Contracts that do not state a specific dollar out-of-pocket amount do not require updating.