Every year, Quebec welcomes tens of thousands of newcomers - permanent residents, skilled workers, refugees, foreign students, asylum seekers - many of whom settle on Montreal's South Shore, particularly in Brossard and surrounding municipalities. Among the first steps to be taken on arrival is access to the Quebec healthcare system - a step that can be a source of confusion, stress and long delays if you're not familiar with RAMQ eligibility rules, waiting periods and the options available during the waiting period.
This guide is intended for people who have recently arrived in Quebec, and for those who accompany or advise them. It clearly outlines the rules governing access to public health insurance coverage, depending on migratory status, the practical steps involved in obtaining a health insurance card, and the care options available during periods not covered by the RAMQ - notably via a private medical clinic accessible on the South Shore.
RAMQ eligibility by migration status
Access to the Régie de l'assurance maladie du Québec depends on a person's legal status in Canada. Permanent residents are eligible for RAMQ coverage as soon as they arrive in Quebec, subject to the waiting period described below. Canadian citizens newly settled in Quebec from another Canadian province are also eligible, subject to specific transition terms. Recognized refugees and protected persons are eligible for RAMQ, but their coverage may initially be provided by the Interim Federal Health Program - IFH - until the provincial card is issued.
Asylum seekers - people who have applied for refugee status but whose claim is still under review - benefit from the Interim Federal Health Program, which covers basic medical care, essential drugs, emergency dental and vision care, for the duration of the process. Foreign students are generally not eligible for RAMQ - they must take out private health insurance, often through their educational institution. Temporary foreign workers are eligible for RAMQ if their work permit is valid for at least six months and they reside in Quebec continuously.
The three-month waiting period: what it means in practice
People who are eligible for RAMQ generally have to wait three months from the time they arrive in Quebec before their health insurance coverage takes effect. This three-month waiting period is one of the biggest practical obstacles to accessing health care for newcomers. During this period, medical care must be paid for privately - except for certain exempt groups, including recognized refugees covered by the IFH program, immigrant investors under certain conditions, and nationals of countries that have signed reciprocal agreements with Quebec.
Countries with which Quebec has social security or health insurance agreements include France, Belgium, Luxembourg, Portugal, Greece, Denmark, Finland, Norway and Sweden. Nationals of these countries may benefit from an exemption from the waiting period or immediate coverage under certain conditions - it is advisable to check the specific terms with the RAMQ or the embassy concerned. For all other eligible newcomers, it is strongly recommended that you take out temporary private health insurance to cover the waiting period.
How to obtain your health insurance card
To register with RAMQ, the new resident must submit an application for registration, along with supporting documentation - permanent residency document, work permit, or other official document confirming legal status in Canada and Quebec. The application can be made online on the RAMQ website, by mail, or in person at an RAMQ office. Once the application has been processed and the waiting period has elapsed, the health insurance card is issued and mailed to the address provided.
It is important to register as soon as you arrive in Quebec - even if coverage does not take effect until after the waiting period - so that the card is available at the end of this period. Processing times may vary according to the period and volume of applications. Any change of address must be reported to RAMQ to ensure receipt of the card and communications. The health insurance card must be presented at every medical consultation, hospitalization or access to a health service covered by RAMQ.
Access to medical care during the waiting period or without RAMQ
During the waiting period, or for those not eligible for RAMQ - foreign students, certain temporary workers - access to medical care requires either private insurance or direct payment of consultation fees. Private medical clinics on Montreal's South Shore, like many Clinique Omicron branches, can accommodate patients without a valid health insurance card, for medical consultations billed directly to the patient or reimbursed by private insurance.
Hospital emergency services are available to anyone in Quebec, regardless of administrative status, for urgent medical situations - hospitals do not refuse emergency care for insurance reasons. However, hospitalization and care costs for the uninsured can be very high - several thousand dollars for even a brief hospital stay. Temporary private health insurance, available from many Canadian and international insurers, is therefore highly recommended to cover the waiting period or stay of students and temporary workers not eligible for RAMQ.
Frequently asked questions about access to healthcare for immigrants in Quebec
I've just arrived in Quebec with my permanent residence - when can I use my RAMQ card?
You must first submit your application to RAMQ as soon as you arrive. Once your application has been accepted, the three-month waiting period begins on the date of your arrival in Quebec - not on the date of your application. After three months, your health insurance coverage takes effect and your card is sent to you by mail. If you are a national of a country that has signed an agreement with Quebec - notably France - you may be exempt from this waiting period: check your situation with the RAMQ before incurring private health expenses.
Can I see a doctor at Clinique Omicron if I don't yet have my RAMQ card?
Yes, in many of our branches in Quebec, we can welcome patients without a valid health insurance card for private medical consultations. Consultation fees are billed directly to the patient, and may be reimbursed by private insurance if you have one. Depending on your situation, certain medical procedures may be reimbursed differently - please contact us beforehand to clarify your situation and find out what reimbursement terms apply.
Is my child born in Quebec automatically covered by RAMQ?
A child born in Quebec to a RAMQ-eligible parent is eligible for coverage from birth - with no waiting period. However, the child must be registered with RAMQ within 60 days of birth. If the parents are not eligible for RAMQ - foreign students, workers without permanent status - the child's situation depends on his or her own legal status. A child born in Canada is a Canadian citizen, but RAMQ coverage also depends on habitual residence in Quebec and the parents' status. It is advisable to consult RAMQ directly to clarify the specific situation.
What medical services are covered by the Interim Federal Health Program for Refugees?
The Interim Federal Health Program covers basic medical and hospital care, including medical consultations, emergency hospitalization, essential drugs on the program's formulary, emergency dental care, emergency vision care and certain mental health services. Coverage varies according to the category of beneficiary - recognized refugee, asylum seeker, protected person - and may change according to current federal policy. Health-care providers must be registered with the program to receive coverage. Medical clinics like Clinique Omicron can specify whether they accept IFH coverage for your specific category when you book your appointment.
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