Provincial Plan Replacement Coverage
Employees arriving in Quebec from outside Canada, or returning to Quebec after a long absence, must apply for Quebec Medicare
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). See Eligibility/RAMQ for more information.
From the date of hire, for up to the duration of the 3-month waiting period, McGill University offers its employees (who are under age 65) coverage under Manulife Financial's Provincial Plan Replacement Coverage program. Eligible dependents (under age 65) may also be covered during this 3-month waiting period.
What is Provincial Plan Replacement (PPR) coverage?
The plan contract and division numbers are: Policy 37822 - Division 258
|PPR 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. 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.|
|PPR 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 is subject to a lifetime maximum of $1,000,000 for each person insured|
|Coverage extends to active employees and their dependents only - who are UNDER age 65.|
|Please refer to the Manulife brochure.|
|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 do the following to ensure the child is automatically covered from birth under the PPR plan:
PPR coverage terminates when:
|Questions about coverage?||Address specific questions concerning PPR coverage directly to Manulife at 1-800-268-6195|
Cost of coverage
The employee incurs no expense for coverage during the 3-month waiting period as the University covers the entire cost.
If the employee has any dependents arriving other than during this 3-month waiting period, or if the employee requires and is eligible for this coverage other than during the inital 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
|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.
How to Apply for Provincial Plan Replacement Coverage
|Complete the application form - Application for Provincial Plan Replacement Coverage- (Section 2- Family Information), providing all required information for all covered individuals.|
|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.|
Sign and date the form (Section 3 - Authorization)
Include a copy of the confirmation of registration for Quebec provincial health care letter(s) from the RAMQ
|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 Univerity for the cost of the coverage you need.|
|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.|
|The plan contract and division numbers for this coverage are: Policy 37822 - Division 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.|
|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:
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 on how to apply? Contact the Human Resources Service Centre at (514) 398-4747.
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. 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.
Extended Provincial Plan Replacement (PPR) coverage
When PPR coverage is needed past the initial 3 month waiting period
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.
1. Complete the application form - Application for Provincial Plan Replacement Coverage-:
|Page 1||Family Information||Provide information for all family members requiring coverage|
|Coverage Information||Select the box "Temporary Health Coverage for a Returning Canadian Employee or a New Canadian Resident|
|Page 2||Extended Benefit Pricing||Select the coverage level you require|
|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).