Provincial Plan Replacement Coverage

Employees arriving in Quebec from outside Canada, or returning to Quebec after a long absence, must apply for Quebec Medicare

The Quebec government requires that new arrivals to Quebec or Canadians returning after an extended absence and who no longer qualify for provincial health benefits must satisfy a waiting period of up to three (3) months before becoming eligible for the Quebec Health Insurance Plan (Medicare).

Provincial Plan Replacement Coverage with Manulife

New arrivals to Quebec from outside Canada or returning Canadians:

During the 3-month waiting period, McGill University offers its employees and their dependents (who are under 65) coverage under Manulife Financial's Provincial Plan Replacement Coverage program. Provincial Plan Replacement Coverage (PPR) provides health care benefits similar to those provided to Quebec residents under the Quebec Provincial Health Insurance Plan. It covers emergency and non-emergency health care expenses up to the same levels and subject to the same limitations and user fees as those under the Quebec Health Insurance Plan. The employee incurs no expense for this coverage as the University covers the entire cost for the 3-month period. The employee must apply for this coverage - please see section Applying for Provincial Plan Replacement Coverage.

New arrivals from another Canadian province:

Employees arriving from another Canadian province must apply for Quebec Medicare, however, they do not need to apply for Provincial Plan Replacement Coverage. The employee's other provincial health care plan will cover them for the first three months they are in Quebec. (It is recommended however that the employee confirm their other province's health care coverage.)

For more information, please refer to the Quebec government's website.

Provincial Plan Replacement Coverage:

• Duplicates provincial health care: it provides health care benefits during the waiting period that are similar to those provided to residents of Quebec through the Quebec Health Insurance Plan.  See the RAMQ website for more information.
• Satisfies the requirement that all employees have basic health care coverage, normally provided by the provincial health care plan, so that the non-resident and his/her dependents will be able to participate in McGill University's Supplemental Health plan.
• Coverage extends to active employees and their dependents only - who are UNDER age 65.
• Coverage is subject to a lifetime maximum of $1,000,000 for each person insured.
• Please refer to the Manulife brochure.
  
• Extended PPR coverage may be available past the initial 3-month waiting period. The employee is responsible for the entire cost of this coverage. Contact the HR Service Centre at (514) 398-4747 for more details.

Coverage and benefits terminate on the earliest of:

• Plan member (including their dependents) turns 65
• Acceptance for coverage by the Provincial Plan (eg. RAMQ Quebec Medicare)
• Termination of employment

Any specific inquiries regarding coverage should be made directly to Manulife at 1-800-268-6195. 

Applying for Provincial Plan Replacement Coverage (PPR)

In order to be eligible for Provincial Plan Replacement Coverage, the employee and their dependents (who are all under age 65), must have registered for Quebec Medicare and for coverage under the McGill Supplemental Health Plan. See sections Registering for Quebec Medicare and Registering for coverage under the McGill Benefit Program.

To apply:

• Complete the application form - Application for Provincial Plan Replacement Coverage- (Section 2- Family Information), providing all required information for all covered individuals.
• Sign and date the form (Section 3- Authorization).
• Forward the completed & signed application to the HR Service Centre with proof of registration letter(s) from the RAMQ.

Pending approval:

• HR will send the application to Manulife for consideration.
• The employee will receive notification from HR of the results of Manulife's review. 
• Please note that any medical expenses incurred before coverage is approved may not be covered.

Registering for coverage with the Quebec Health Insurance Plan (Quebec Medicare)

It is important that new arrivals to Quebec and returning Canadians register for provincial health coverage with the Régie de l'assurance-maladie du Québec (RAMQ) upon arrival.  For more information on how to register, please refer to the RAMQ website.  The Régie may be contacted by phone at: (514) 864-3411

Registering for coverage under the McGill Benefit Program

To qualify for coverage under the McGill Supplemental Health Plan, the employee and and their eligible dependents must have provincial health care benefits.

When they register with the Régie, they will be given a letter confirming their registration and the effective date of their provincial health care coverage. It is important that they provide a copy of this letter when they enroll in the McGill Employee Benefits Program. This letter will serve as proof of their registration with the Régie.

Claiming expenses under the Provincial Plan Replacement Coverage benefit (Policy 37822-258)

The benefit year is from January 1 to December 31. All claims must be received by our insurer within 90 days of the end of the benefit year — that is, by March 31st. Claims received after this date will not be paid.

Please note that members may be required to pay the health care practitioner directly for services rendered and then submit a claim to Manulife Financial.

Preparing the claim:

1) Use a regular Manulife Health Claim form Health Claim Form.

2) When completing the claim form indicate:

• Plan contract number: Beside 85210, indicate 37822-258
• Plan member certificate number: Indicate both your McGill ID number & your PPR certificate number (indicated on Manulife's confirmation of PPR coverage letter)

3) Attach all original receipts.

4) Keep a copy for your files.

5) Mail to Manulife at: 

Manulife Financial
Group Claims Department
P.O. Box 2580, Stn B
Montreal, Qc H3B 5C6