Quebec Residents Face $10 Million Healthcare Bill in Other Provinces

Quebec residents incurred over $10 million in out-of-pocket expenses for health care received in other provinces last year. The lack of reciprocal billing agreements for most medical services between Quebec and other jurisdictions forces Quebecers to pay upfront for health care when traveling outside the province. Subsequently, they can submit these expenses to Quebec’s public health insurance board, which may not fully reimburse them.

Data obtained by The Canadian Press through an access-to-information request revealed that in 2024, Quebecers submitted $12.6 million in claims for services rendered by health care professionals in other Canadian provinces. Of this amount, the insurance board reimbursed only $2.3 million. Health Canada noted in an email that “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.”

The disparity in billing rates can be significant. The Quebec Health Department encourages residents to consider private medical insurance when traveling outside the province. Charles Shaver, a retired internal medicine doctor based in Ottawa, highlighted that his clinic refrained from treating out-of-province patients who could not or would not pay for care. He explained that physicians and private clinics in eastern Ontario often charge Quebec patients at rates established by the Ontario Medical Association, which are typically higher than those set by the Ontario Health Insurance Plan.

“It’s not a good situation,” Shaver remarked, emphasizing the challenges faced by patients from Quebec seeking care in other provinces.

Physicians from other jurisdictions have the option to either bill Quebec patients directly or process their fees through the Quebec health insurance board for reimbursement. Unfortunately, the board does not usually cover the full costs. In 2024, the Quebec health insurance board was billed $8.9 million by health care professionals outside Quebec but reimbursed only $7 million.

Under the Canada Health Act, provinces and territories are required to cover the cost of emergency medical and hospital services for their residents temporarily outside their home province. While Quebec has established reciprocal billing agreements for hospital insurance with all provinces and territories, allowing residents to receive hospital care without upfront payments, the Health Department has indicated that there are no current plans to implement reciprocal billing agreements for other medical services.

This situation raises ongoing concerns about access to health care for Quebec residents needing services while traveling. As the landscape of health care continues to evolve, the implications of these billing practices remain significant for residents across the province.