Drug, Health & Travel Insurance

The law on prescription drug insurance provides that if you are established in Quebec and eligible for a private plan, you must cover your spouse and your children.

Spouse, under the law, means any eligible person who resides in Canada and who, in order to be entitled to benefits at the time of the claim, either:

• Is united to the member through marriage.
• Has lived with the member in a common-law relationship for at least 12 months and has not been separated for 90 days or more due to the breakdown of their union; or:
• Lives in a common-law relationship with the member and had a child with them and has not been separated for 90 days or more due to the breakdown of their union.

Dependent child, under the law, means any qualifying single person who resides in Canada, and who:

• Is under 21 years of age, and over whom the participant or the participant’s spouse exercises parental authority or exercised parental authority until they reached the age of majority.
• Is 25 years old or less and attends, as a duly registered student, an educational institution full-time and over which the participant or the participant’s spouse would exercise parental authority if they were a minor.
• Is of legal age and suffers from a functional deficiency referred to in the regulations for the application of the Régime général d’assurance médicaments adopted by the Government of Quebec, a deficiency which must have occurred when the person’s condition corresponded to what is expected in a) or b), in this definition, and it being understood that to be considered as a person with a functional deficiency, the dependent child must reside with the member or spouse of the member who would exercise parental authority over the disabled person if they were a minor. It is understood that the functional deficiency will be defined according to what is provided for in the regulations of application of any provincial law, as the case may be.

Your insurance plan provides reimbursement for medications. However, some medications must first be authorized by the insurer before being reimbursed under your plan’s terms. To check if a drug requires prior authorization, click here.

Please note that the following medications are not subject to a prior authorization form when you have option 1 or 2 of the FMSQ plan.

• Aubagio
• Avonex
• Betaseron
• Copaxone
• Extavia
• Gleevec
• Tecfidera

No, you don’t have to notify the insurer before your departure. Your insurance is valid as long as the premium has been paid. However, if your health condition is not stable in the days leading up to your departure, you will need to contact the insurer’s travel assistance service to make sure you are covered during your stay abroad. You’ll find the contact numbers on the back of your insurance card.

Yes, except for sports appearing in the “Exclusion” section of your brochure. You can access your brochure in our Customer Area.

You must contact the insurer’s travel assistance service immediately. The numbers to contact appear on the back of the insurance card you received when you enrolled.

The assistance service will be able to direct you to a clinic or hospital able to offer you care, as well as open your claim file and, where possible, make arrangements for the payment of medical expenses.

Yes, absolutely. The travel assistance service will direct you to the appropriate clinic or hospital. Failure to contact the insurer’s travel assistance service (unless it was possible for you to do so before receiving medical treatment) may result in the claim being denied.

The Assistance Service team is available 24 hours a day, 7 days a week to answer your questions.

To find out which regions or countries are affected by a consular notification, visit the Government of Canada website.

Unfortunately, no. Your insurance contract specifies that a travel credit issued by a travel service provider is considered a refund. You cannot therefore be reimbursed by your trip cancellation insurance for this travel credit, even if that is what you would have preferred.

No. It is your responsibility to be aware of the requirements prior to boarding and to ensure that you meet them. If you do not have a valid passport or visa as required by your travel destination, you cannot make a claim under your trip cancellation insurance. Requirements may vary from country to country, and even from one travel service provider to another. That’s why it’s your responsibility to find out before you buy.