How does insurance coverage work after a change in insurance?

Question

Our daughter; 6 months old, takes her hemangiol / propanolol since she was 3 months old. - Mixed infantile hemangioma on the eyelid (exception drug vital for her eyesight). - Ramq covers 100%. BUT my spouse is starting a new job with private group insurance. He is thinking of taking the big family insurance

Naji-tom Samaha · Accepted Answer

Hemangiol is an exception drug for which the prescriber must fill out a form and send it to the RAMQ to evaluate the coverage of the drug. In Quebec, private insurers must provide drug coverage that is at least equivalent to the public plan. Therefore, an insurer may either cover the drug or require a formulary just like the RAMQ. Your spouse will need to check with his or her insurer for the terms of coverage. As written, drugs are usually covered at 100% for children (among others), but this may not be the case for private insurers. Again, your spouse will need to check with the insurer. Sincerely, Tom Samaha, pharmacist