Health and dental insurance
Dentist, glasses, physiotherapy, psychologist: the care the public plan does not pay for.
In brief
Health and dental insurance
The public plan covers doctors and hospitals, but not the dentist, the optometrist, the physiotherapist or a psychologist in private practice. For employees, group insurance takes over. For everyone else, individual health insurance avoids paying for every visit out of pocket.
How it works
You choose a plan to fit your needs: a basic option for everyday care or a more complete one. The insurer reimburses a percentage of eligible costs, up to the maximums set for each category.
In Québec, the law requires every eligible person to have prescription drug coverage. If you do not have access to a group plan, you are covered by the RAMQ public plan. An individual plan can complement that protection for other care.
The advantages
A predictable health budget
A monthly premium instead of surprise bills.
Faster access to care
In private clinics, with no waiting list for many services.
The whole family covered
Spouse and children can be included.
A smooth transition
For those leaving a job with group insurance or retiring.
Who is it for?
- The self-employed
- No employer pays for a plan for them.
- New retirees
- Group insurance often ends at retirement.
- People between jobs
- To avoid a gap in coverage.
- Small businesses
- That prefer to offer their employees a simple solution, or a group plan.
A real-life example
Karim, a self-employed graphic designer, his spouse and their two children have no group insurance. Between the dentist, their daughter's glasses and physiotherapy treatments, the annual bill was over $2,500.
With an individual family plan, a good part of these costs is reimbursed every year, and their drugs remain covered by the RAMQ public plan in which the family is enrolled.
The options available
| Basic plan | Preventive dental care, vision, a few professionals. |
|---|---|
| Comprehensive plan | Major dental work, higher maximums, more professionals. |
| Travel coverage included | Some plans add emergency travel protection. |
| Group plan for a business | From two employees, a group plan can be more advantageous. |
Key terms
| Reimbursement percentage | The share of costs paid by the insurer, for example 70% or 80%. |
|---|---|
| Annual maximum | The ceiling reimbursed per category and per year. |
| Waiting period | Some coverage, such as major dental work, only applies after a membership period. |
| Public prescription drug insurance plan | The RAMQ plan, mandatory for eligible people without a group plan. |
| Health professionals | Physiotherapist, chiropractor, psychologist, massage therapist, depending on the plan. |
What to watch for
- The maximums per category: compare them with what you actually spend.
- Waiting periods for major dental work.
- Exclusions and pre-existing conditions.
- The obligation to have drug coverage in Québec.
The right questions to ask
- How much did I spend on care last year?
- Which plan really covers my needs?
- Are my drugs covered by the RAMQ or another plan?
- Could my business offer a group plan?
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Other protections
Sources :
- Régie de l'assurance maladie du Québec (RAMQ), public prescription drug insurance plan
- Act respecting prescription drug insurance (Québec)
- Standard insurer contracts, reviewed in October 2026
General information: this content is not personalized advice. Guarantees, exclusions and premiums are those of the insurer's contract. Images: Pexels photographs (Pexels licence) and illustrations generated by artificial intelligence; the people shown are models or fictional characters.