Provincial plan replacement coverage

Employees arriving in Quebec from outside Canada, or returning to Quebec after a long absence, only become eligible for Quebec Medicare after a waiting period of up to three (3) months (see Eligibility/RAMQ for more information). 

Since all staff are required to have basic health care coverage, from the date of hire and for up to the duration of the 3-month waiting period, Manulife offers Provincial Plan Replacement coverage to employees, who are under age 65 and their eligible dependents who are also under age 65.

What is Provincial Plan Replacement (PPR) coverage?

  • PPR duplicates provincial health care by providing health care benefits similar to those provided to residents of Quebec through the Quebec Health Insurance Plan.
  • PPR satisfies the requirement that all McGill employees have basic health care coverage, allowing you and your dependents to participate in McGill's Supplemental Health plan.
  • Coverage is subject to a lifetime maximum of $1,000,000 for each person insured.
  • Coverage extends to active employees under age 65, and to their under-65 dependents only.

Plan details

The plan contract is 37822 and the division number is 258

Questions concerning PPR coverage can be addressed directly to Manulife at 1-800-268-6195.

Cost of coverage

The University covers the cost of premiums. The employee incurs no expense for coverage during the initial three (3) month waiting period.

If the employee has any dependents arriving other than during this initial 3-month waiting period, or if the employee requires and is eligible for this coverage other than during the initial 3-month period, the employee will be responsible for the entire cost of their coverage. Refer to the application for provincial plan replacement coverage for information on costs.

Applying for coverage

Eligibility

To be eligible for Provincial Plan Replacement (PPR) coverage, the employee and their dependents must be:

  1. Registered with the RAMQ for Quebec Provincial Health care
  2. Registered for coverage under the McGill Supplemental Health Plan

For information on how to register with RAMQ, please refer to the RAMQ website or Quebec Health Insurance pamphletThe Régie can be contacted by phone at: (514) 864-3411.

How to apply

  1. Complete the Application for Provincial Plan Replacement Coverage (Section 2- Family Information), providing all required information for all covered individuals.
  2. If you are expecting a child while enrolled for PPR coverage: Select family coverage and indicate "unborn child' as the child's name and the expected delivery date as the date of birth.
  3. Sign and date the form (Section 3 - Authorization)
  4. Include a copy of the confirmation of registration for Quebec provincial health care letter(s) from the RAMQ
  5. Forward the completed and signed application & the RAMQ letters to the Human Resources Service Centre without delay.

If you are applying for coverage for dependents who have arrived after your initial 3-month waiting period and are responsible for the cost of coverage, include a personal cheque made payable to McGill University for the cost of the coverage you need.

Pending approval

  • Human Resources will send the application to Manulife for consideration.
  • PPR coverage can only be confirmed once Human Resources receives Manulife's approval.
  • The employee will receive from Human Resources notification of Manulife's review (letter from Manulife).

Please note that any medical expenses incurred before coverage has been approved may not be covered.

PPR coverage for an unborn child

If you are expecting a child during the 3 month waiting period for Quebec Provincial Health Care, you must: 

  • Apply for family Provincial Plan Replacement Coverage
  • Indicate "unborn child" in the name of the dependent section
  • Indicate the expected delivery date as the date of birth

Claiming expenses

The plan contract is 37822 and the division number is 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, March 31st. Claims received after this date will not be paid.

Plan members may be required to pay their health care practitioner directly for services rendered and then submit a claim to Manulife Financial for reimbursement.

Preparing the claim   

1. Use a regular health benefit claim form.

2. When completing the claim form you will need to indicate: 

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

3. Attach the original receipts.

4. Keep a copy of the claim (including receipts) for your files.

5. Mail the claim to Manulife at the address indicated on the claim form.                                                       

Questions? Contact the Human Resources Service Centre at (514) 398-4747.

Coverage termination

PPR coverage terminates when:

  • The plan member turns 65 (including their dependents)
  • The employee (and their dependents) is accepted for coverage by the Provincial Health Plan (RAMQ)
  • Employment terminates

New arrivals from another Canadian province

Employees arriving from another Canadian province must apply for Quebec Provincial Health Care. However, they do not need to apply for Provincial Plan Replacement Coverage, as the employee's other provincial health care plan will cover them for the first three months they are in Quebec. Please confirm with your province. For more information, refer to the Quebec government's website

Extended Provincial Plan Replacement (PPR) coverage

If you and/or your spouse and dependents require Provincial Plan Replacement Coverage longer than the initial three-month period, you may apply for Extended Provincial Plan Replacement Coverage.

Coverage is similar to initial PPR coverage, however you are responsible for the entire cost of this coverage.

To apply:

1. Complete the application for Provincial Plan Replacement Coverage

  • On Page 1, provide information for all family members requiring coverage. Under coverage Information, select the box "Temporary Health Coverage for a Returning Canadian Employee or a New Canadian Resident.
  • On Page 2, under Extended Benefit Pricing, select the coverage level you require. Under Authorization, sign and date the application form.

2. Attach a personal cheque made payable to McGill University for the required amount. (Payment must be made for periods of 3 months.)
3. Forward the completed & signed application form to the HR Service Centre WELL BEFORE the end of the initial 3-month period of coverage (this will allow time to process your request). 

If additional periods of extended coverage are required, please provide an explanation of the steps being taken to arrange eligibility for RAMQ coverage. Manulife needs to know that you are actively pursuing eligibility for RAMQ coverage. If you have any questions, please contact the HR Service Centre at (514) 398-4747 or hr.hr [at] mcgill.ca