Moving to Quebec comes with a long list of administrative steps, but few matter as much as registering with the Régie de l’assurance maladie du Québec (RAMQ), the province’s public health insurance plan. Without a valid health insurance card, care is not free, and a single day in hospital can cost more than $3,000 before doctors’ fees. Based on RAMQ’s official rules, here is everything you need to know: who is eligible, how the three-month “waiting period” works, who skips it, and how to register correctly as soon as you arrive.

Who is eligible for RAMQ? Settled vs. temporary status

RAMQ recognizes two main statuses, and which one applies to you determines your rights.

Person settled in Quebec — you must meet three conditions: have your main residence in Quebec, be present in Quebec at least 183 days per calendar year, and hold authorization to remain in Canada (Canadian citizen, permanent resident, refugee or protected person, a person born outside Canada recognized by Indigenous Services Canada, a person authorized to apply for permanent residence, or the holder of a permit granted in exceptional circumstances).

Person temporarily staying in Quebec — you must not be absent from Quebec for more than 21 consecutive days, and hold a status such as an eligible work permit valid for more than 6 months, a study or internship permit if your country has signed a social security agreement with Quebec, a Ministry of Education fellowship, or be a child under 18 or spouse of someone in one of these situations.

Some people are not eligible at all: tourists, students from a country without a social security agreement, holders of a stay authorization of less than 6 months, or an open work permit (with some exceptions). If this applies to you, private travel insurance is strongly recommended before you even arrive — a day in hospital in Quebec can cost more than $3,000, plus doctors’ fees, and it will not be reimbursed.

The three-month waiting period, explained

Whether you’re arriving from another country or another Canadian province, your RAMQ coverage generally begins a maximum of three months after you register — this is known as the waiting period. The clock starts on your registration date, provided you are physically in Quebec and submit all required documents. You then have 12 months to provide any missing documents, or your eligibility start date will be pushed back further.

If you’re arriving from another Canadian province or territory, you remain covered under your home province’s plan during this period, thanks to interprovincial agreements.

Since RAMQ does not reimburse care received before your eligibility start date, it’s strongly recommended to take out temporary private insurance as soon as you arrive in Quebec.

Who is exempt from the waiting period?

Several situations allow you to be covered as soon as you register, without waiting three months:

• You are arriving from a country that has signed a social security agreement with Quebec (for example France or Belgium)
• You are a refugee or protected person in Canada
• You are a Canadian citizen repatriated by the government
• You are a recipient of last-resort financial assistance
• You are a fellowship recipient from the Ministry of Education or Higher Education
• You are working in Quebec under the Seasonal Agricultural Worker Program or the Temporary Foreign Worker Program’s primary agricultural stream, coming from Mexico, Guatemala, Honduras or El Salvador
• Children under 18 are never subject to the waiting period

How to register for RAMQ: step by step

1. Gather your valid identity and immigration documents (passport, Quebec Selection Certificate, study or work permit, confirmation of permanent residence, depending on your situation)
2. Complete the registration form that matches your status on the RAMQ website
3. Submit your application as early as possible after arriving: the sooner you register, the sooner the waiting period starts running
4. Provide any missing documents within 12 months of registering to avoid a delay in your eligibility start date
5. Once your file is accepted, RAMQ mails you your health insurance card

For the exact list of documents required for your specific immigration status, see RAMQ’s official page on eligibility conditions, which breaks down each category in detail.

What to do during the waiting period

During the waiting period, some care remains free regardless of your status:

• Care needed by victims of domestic or conjugal violence, or sexual assault
• Care related to pregnancy, childbirth or termination of pregnancy
• Treatment of infectious diseases that have an impact on public health

For everything else, care received during the waiting period is at your own expense and will not be reimbursed retroactively by RAMQ. That’s why taking out temporary private insurance (Blue Cross, Desjardins, La Capitale, Sun Life, Manulife, Great-West, among others) as soon as you arrive is common practice among newcomers, especially for families with children or anyone with known health needs.

Renewing your card or re-registering after a status change

People settled in Quebec for more than a year (citizens, permanent residents, refugees) usually receive a renewal notice three months before their card expires. People temporarily staying in Quebec — foreign students, temporary workers — cannot simply renew: they must re-register every time their immigration status changes or their card expires, for example when moving from a study permit to a work permit, or from a work permit to permanent residence.

Another key point: to remain eligible, a settled person must not be absent from Quebec for 183 days or more (consecutive or not) in a calendar year, or they lose eligibility for the entire year and must reimburse any care received. People on a temporary stay must not be absent for more than 21 consecutive days.

For the procedure that applies to your situation, see the official page Obtain a new Health Insurance Card.

Frequently asked questions

Does the waiting period apply to Canadian citizens? Yes — even a Canadian citizen moving to Quebec from another province is subject to the waiting period, unless they are under 18.

Can I see a doctor without a RAMQ card? Yes, but you’ll have to pay out of pocket, and you won’t be reimbursed if you weren’t eligible at the time of care.

What if my card expired while I was travelling? If your absence was temporary (studies, work, vacation), you must renew your card as soon as you return; if you settled elsewhere, you must re-register.

I paid for covered care — can I get reimbursed? If your card was valid but you didn’t have it with you, you can request a reimbursement. If your card had expired, you must renew it first before requesting one.

Good to know / What to watch for

• Register with RAMQ as early as possible after arriving: the waiting period starts from your registration date, not your arrival date.
• Keep proof of your presence in Quebec (lease, bills, statements) — RAMQ can ask for it to confirm your ongoing eligibility.
• An open work permit or an authorization of less than 6 months generally does not give access to RAMQ — check your exact category before assuming you’re eligible.
• Rules and exemptions can be updated by RAMQ; always check the current information on the official site before planning your steps.
• For more on the first steps after arriving in Quebec, see our newcomer’s guide to Quebec, and our Immigration section for updates on federal and provincial programs.
• Find all our regional coverage in the Quebec section.

Sources

• RAMQ — Know the eligibility conditions for health insurance
• RAMQ — Obtain a new Health Insurance Card