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Quebec residents paid more than $10 million out of pocket to receive health care in other provinces last year.
Unlike other provinces, Quebec has opted not to adopt reciprocal billing agreements with other jurisdictions for most medical services.
That means Quebecers travelling outside the province have to pay for health care upfront and then submit their expenses to Quebec’s public health insurance board, which may not fully reimburse the costs. Residents of other provinces who need medical services while in Quebec must also pay out of pocket.
Data obtained by The Canadian Press through an access-to-information request show that in 2024, Quebecers submitted $12.6 million in expenses to the health insurance board for services provided by professionals in other Canadian provinces. Of this amount, the board reimbursed only $2.3 million.
“Since Quebec does not have reciprocal billing agreements for medical services with other provinces, Quebec residents generally pay for these services out of pocket and are then reimbursed according to Quebec’s own rates, rather than the host province’s rates,” Health Canada wrote in an email to The Canadian Press.
However, the difference in the rates between provinces can be significant. The Quebec Health Department says it encourages people to take out private medical insurance for any travel outside the province.
Charles Shaver, a retired internal medicine doctor in Ottawa, said his clinic had a policy not to see out-of-province patients who could not or would not pay for care. He said doctors and private clinics in eastern Ontario often bill Quebec patients at rates set by the Ontario Medical Association, which are higher than those set by the government-run Ontario Health Insurance Plan.
“It’s not a good situation,” he said.
Physicians from other provinces can choose to bill Quebec patients directly or send their fees to the Quebec health insurance board for reimbursement. But the insurance board generally does not reimburse them in full.
In 2024, the Quebec health insurance board was billed $8.9 million by professionals outside Quebec and reimbursed only $7 million.
Under the Canada Health Act, provinces and territories must cover the cost of emergency medical and hospital services for their residents when they are temporarily outside their province.
Quebec has signed reciprocal billing agreements for hospital insurance with each province and territory, which allows Quebec residents to receive hospital care anywhere in Canada without having to pay for it.
However, the Health Department said there are no plans to sign reciprocal billing agreements for other medical services.
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