Prescription Drug Insurance Plan

Transcription

1 Ministère du Revenu du Québec Prescription Drug Insurance Plan

2 The information contained in this brochure does not constitute a legal interpretation of the Taxation Act or any other legislation. ISBN Legal deposit - Bibliothèque nationale du Québec, 2003 Legal deposit National Library of Canada, 2003

3 Contents Introduction Are you covered by a private plan?... 7 What if you are covered by a private plan? Becoming a member of the public prescription drug insurance plan How much does coverage cost? Paying the premium Paying the contribution Inform your pharmacist You may be entitled to a tax credit... 14

4 Introduction Since the basic prescription drug insurance plan came into effect in 1997, all persons who have a health insurance card issued by the Régie de l assurance maladie du Québec (RAMQ) must ensure that they have basic prescription drug insurance coverage. There are two ways for you to obtain basic prescription drug insurance: through a private group insurance plan, that is, a group insurance or employee benefit plan of which you must or can become a member by reason of your current or former employment, your profession or any other occupation. You may be covered under your spouse s, your father s or your mother s plan; or through the public prescription drug insurance plan administered by the RAMQ. You are required to become a member of a private plan 1 if that option is available to you. If you do not have access to a private plan, you must contact the RAMQ without fail (if you have not already done so) in order to obtain coverage under the public prescription drug insurance plan administered by the RAMQ. The basic prescription drug insurance plan covers only drugs that are purchased in Québec and included on the drug list published by the RAMQ. 1. In this document, private plan means private group insurance plan. 5

5 IMPORTANT This brochure contains tax information regarding the public prescription drug insurance plan. To help you better understand the plan, we have also included general information from the RAMQ. For additional information, you can consult the RAMQ brochure Prescription Drug Insurance: Important Information About the Public Plan, available in pharmacies, or you can contact the RAMQ. All tax information is highlighted in yellow. For additional information concerning these passages, contact the Ministère du Revenu office in your area. 6

6 Are you covered by a private plan? Many people are covered or have the possibility of being covered under private plans by reason of their current or former employment, their profession or their spouse s, father s or mother s private plan. If you are employed but are not sure you are covered by a private plan, you should check with your employer. If you had the option of becoming a member of a private plan and you did not do so, you will have to pay an amount equivalent to the premium under the public prescription drug insurance plan when you file your income tax return. Even so, you will be denied coverage under the public plan. If you were registered with the public plan even though you were not entitled to coverage, you must immediately cancel your registration and become a member of the private plan that is available to you. Note that you will be required to refund amounts paid by the RAMQ for prescription drugs that you purchased during this period. Certain private plans sell supplementary insurance. Such coverage is complementary to the basic coverage offered under the public plan and may cover prescription drugs that are not covered by the public plan. Find out what possibilities your insurer offers. 7

7 What if you are covered by a private plan? When you have a prescription filled, just follow the procedure indicated by your insurance company. Where necessary, contact your insurer for additional information on the procedure. If you are covered by a private plan for the entire year, you are not obliged to pay a premium under the public plan. You must, however, so inform the Ministère du Revenu when you file your income tax return, as the Ministère is responsible for collecting the premium. Simply enter the number corresponding to your situation in box 449 of your tax return. In the guide to the personal income tax return (TP-1.G-V), you will find a list of numbers covering the full range of situations. If you were not covered by a group insurance plan throughout the year, read the section How much does coverage cost? on page 10. 8

8 Becoming a member of the public prescription drug insurance plan If you do not have access to a private plan, you must be covered under the public prescription drug insurance plan. To that end, you must first become a member of the public plan, by calling the RAMQ or visiting one of its offices. Québec 1125, chemin Saint-Louis Sillery (Québec) G1S 1E7 (418) Montréal 425, boulevard De Maisonneuve Ouest, 3 e étage Montréal (Québec) H3A 3G5 (514) Elsewhere in Québec (toll-free) Information service for persons with a hearing impairment Québec: (418) Elsewhere in Québec, toll-free:

9 How much does coverage cost? If you are covered by the public plan, the following two amounts constitute your financial participation in the plan: Premium: An annual amount per adult that is determined on the basis of income and paid when the income tax return is filed. Contribution: The portion of a bill that you must pay upon the purchase of prescription drugs at a pharmacy. Paying the premium You must pay the premium annually, when you file your income tax return, regardless of whether you purchased prescription drugs during the year. The Ministère du Revenu is responsible for collecting the premium. The amount of your premium is determined on the basis of your income and your personal or family situation. Complete Schedule K of your tax return to calculate the amount of your premium. 10

10 However, you are not required to pay a premium or complete Schedule K if one of the situations below applied to you: You were covered throughout the year by basic prescription drug insurance provided by a private plan. You were covered throughout the year by basic prescription drug insurance provided by a private plan of which your spouse, father or mother was a member. You received employment insurance benefits throughout the year. Throughout the year, you were under 18 years of age and were not married. You were an Indian registered with the Department of Indian Affairs and Northern Development, or were recognized as an Inuit by that department. Throughout the year, you were a beneficiary under the James Bay and Northern Québec Agreement or the Northeastern Québec Agreement. You were absent from Québec throughout the year. Your net family income was lower than the amount specified at line 447 of the guide to the personal income tax return (TP-1.G-V). IMPORTANT If one of these situations applied to you, you are not required to pay a premium. However, you must enter the number corresponding to your situation in box 449 of your tax return. Refer to the guide to the personal income tax return (TP-1.G-V) for information in this regard. 11

11 Special cases You were covered by a private plan for part of the year. You must complete Schedule K and attach it to your income tax return even if you were not registered for the public plan and did not buy prescription drugs. You are a student and your parents are covered by the public plan. You are not required to pay a premium if you attended an educational institution full-time during the winter and fall terms, were 26 years of age or under and did not have a spouse. You must, however, complete Schedule K and attach it to your income tax return. If you were a full-time student for only part of the year, you must complete Schedule K and attach it to your income tax return, even if you were not registered for the public plan and did not buy prescription drugs. Paying the contribution When you buy prescription drugs covered by the public plan at a pharmacy, your contribution is calculated monthly and takes the form of a deductible and a co-insurance amount. The deductible is a fixed amount that constitutes the first portion of the drug costs. In most cases, you pay the deductible in full when making your first purchase of prescription drugs during the month. 12

12 The co-insurance amount is the portion of the drug costs that you must pay once you have paid the deductible. Thus, when your drug costs exceed the deductible, you pay a percentage of the remainder. The maximum contribution is the maximum amount you may be required to pay each month for your drug purchases, and consists of the deductible plus the co-insurance amount. Once you have reached your maximum contribution, you don t pay anything for the prescription drugs you purchase during the rest of the month, provided they are covered by the public plan. Inform your pharmacist If you are insured under the public plan, you must so inform your pharmacist when you have your prescription filled. You must also provide the pharmacist with your health insurance card and, if applicable, your claim booklet. The pharmacist will give you a receipt showing your contribution towards your purchase. The receipt will also include a statement of your contributions for the month. 13

13 You may be entitled to a tax credit You may be able to claim a tax credit for your medical expenses. If so, you can include in your medical expenses the premium paid under the public plan, as well as your contribution towards prescription drug purchases. To apply for the tax credit, complete Schedule B and attach it to your income tax return. For additional information, refer to the guide to the personal income tax return (TP-1.G-V). 14