RAMQ, doctors sound alarm on insurance delays

By Ruby Irene Pratka – Local Journalism Initiative

The Régie d’assurance-maladie du Québec (RAMQ) is warning Quebecers who are applying for prescription medication insurance through the public system that they may have to temporarily take out a private insurance policy due to longer-than-usual processing delays.

Quebecers are required by law to have some form of prescription medication insurance, and many people get prescription medication insurance through their employers. Those who do not are required to apply for it through the public system. If someone loses their job or changes employers, from a company which provides prescription medication insurance to one that does not, they need to apply for prescription medication insurance through the RAMQ. That can take time – more time than usual. The RAMQ advises people who are in the process of applying to get private insurance to cover the 60-day waiting period.

“We are missing agents, and we have had a lot more registrations than in the past few years, due largely to the return of foreign students, the end of some exceptions put in place during the pandemic and the passing of Bill 83, which has made thousands of [previously ineligible] children of immigrant parents eligible for coverage,” RAMQ spokesperson Caroline Dupont explains. “Out of transparency, we wanted to warn [applicants] about the waiting period so they wouldn’t end up with surprise bills.”

The warning posted on the agency website was worrisome for the provincewide doctors’ group Médecins québécois pour le régime public, who support a more accessible public health system. MQRP president Dr. Isabelle Leblanc warns that longer delays mean more vulnerable applicants may fall through the cracks.

“We’re talking about people who have lost their jobs and lost their medication insurance, and are now being told they have to pay their medication out of pocket or get private insurance,” she says. “Private medical insurance can be hard to access; it costs a lot and if you have a chronic medical condition, companies may not want to insure you. People who have not renewed their insurance because they are disorganized or have trouble navigating the online system are going to have trouble finding private insurance, because it takes research. The fact that a public insurer is telling people to go private – what does that say about how our system works?”

She added that although the online application process was relatively straightforward, people without internet access or computer literacy, who apply by phone, have been experiencing long delays.

She called on the RAMQ to assume that people buying prescription medication who don’t have existing insurance are eligible for the provincial program until proof of the contrary. “If we cover a few people who are ineligible, that shouldn’t be the end of the world,” she says. “Cover first, ask questions later.”

The RAMQ does not support that approach. “The process [of applying for services] isn’t automatic, because we need to administer the public system diligently and make verifications in order to issue cards solely to eligible people,” says Dupont. “Those verifications are part of our mission.” She says the agency recently hired 40 new processing agents and streamlined the health insurance application process for certain categories of immigrants and foreign workers “should help improve the process” for all applicants, and make it easier for people who need to apply for insurance over the phone to do so.

Leblanc suggests that anyone who is concerned about their ongoing eligibility for prescription medication insurance pay attention to the expiration dates on any documentation, speak to their pharmacist and contact their MNA’s office if they are unable to speak to a RAMQ employee.

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