The Régie de l’assurance maladie du Québec (RAMQ) (Québec Health Insurance Plan) is a government-funded benefit that includes limited public dental coverage for all Quebec residents.
For adults not receiving financial assistance, dental coverage under the Québec Health Insurance Plan covers certain oral surgery services, examinations, local or general anesthesia, and X-rays when treatment is performed in a hospital. With the exception of those receiving financial assistance, adult patients are responsible for the costs of tooth and root extractions.
Individuals receiving financial assistance can get dental care under the Québec Health Insurance Plan at a dental clinic. After 12 months in a financial assistance program, they can receive exams, X-rays, fillings, extractions, and other services for free. After 24 months, acrylic prostheses are also included with pre-approval.
Children below the age of 10 in Québec have access to the following services at no cost when provided by a dentist in a dental clinic or hospital:
- Annual routine examination and emergency examination
- X-rays
- Local or general anesthesia
- Grey amalgam fillings on the premolars and molars
- Fillings using aesthetic materials in certain cases
- Tooth and root extractions
- Endodontic treatment
- Pulpotomy and pulpectomy for the primary teeth. For the permanent teeth, pulpotomy is covered only under general anesthesia
- Prefabricated crowns
- The oral surgery services covered for all (noted above)
The following services are not covered, regardless of age, situation or location received:
- Apicoectomy (root end surgery)
- Whitening
- Veneers
- Dental implants
- Orthodontics
- Periodontics
- Recementing of crowns other than prefabricated
- Pit and fissure sealants
Under certain conditions, patients may obtain covered services from dental hygienists who practice independently and who have signed an agreement with RAMQ. The services can be performed in a dental office, in a mobile clinic or at home.
To receive dental care under the Québec Health Insurance Plan, patients must meet the eligibility requirements set by RAMQ. If eligible, patients will receive a health insurance card allowing access to covered dental services.
A person born in Québec is eligible and automatically registered for the health insurance plan if their parents are eligible at the time of their birth. There is no application process to follow for their registration.
To determine eligibility for public health insurance, an individual must fall into one of two status categories. These are:
- A person established in Québec
- A person temporarily staying in Québec
Eligible newcomers to Québec can apply online for public health insurance.
Once approved, the applicant will receive their health insurance card in the mail.
To access dental benefits under the Québec Health Insurance Plan, qualified individuals must present their insurance card to their dental care provider. The service provider will directly bill the RAMQ for the covered services.
Key Québec Health Insurance Plan Details
Before visiting the dentist, it’s crucial to understand which services are covered. For example, if an individual has received financial assistance for less than a year, only emergency care will be covered. Being aware of these details can help patients avoid unexpected expenses.
After signing up for provincial health coverage, there is a waiting period of up to three months. During this time, individuals will not be covered or reimbursed for dental services received.
If an individual believes that they were wrongly charged for covered services, they may submit a request for reimbursement. This application can be filed, along with the invoice, up to five years after the date of payment.
If an individual’s health insurance card was expired, or if they were unable to present it at the time of service, they can apply for reimbursement. This can be done for up to one year after service was rendered.
FAQs
Will the CDCP and RAMQ coordinate benefits?
At this time, the CDCP will not reimburse services covered by Québec dental programs under the RAMQ.
Can I get dental coverage for my children if I am not receiving financial assistance but am a resident of Québec?
Yes, all children under the age of 10 residing in Québec can receive basic dental care services as long as they have a RAMQ health insurance card.
References
- Government of Quebec, Dental Services
- Assurance Dentaire, Dental Care
- Government of Canada, Coordination of Benefits
- Government of Quebec, Eligibility Conditions
- Government of Quebec, Register for Health Insurance
*The content provided in this article, including text, graphics, and referenced material, is intended for informational purposes only and is not a substitute for professional dental advice, diagnosis, or treatment. Always consult with your dentist or another qualified oral health professional for questions regarding your dental condition. Never disregard professional dental advice or delay seeking it based on information from this article. If you believe you have a dental emergency, contact your dentist, or seek immediate assistance from an oral healthcare professional.