Quebecers pay millions of dollars each year in health care costs in other provinces

Quebec residents paid more than $10 million out of pocket last year to receive medical care in other provinces.

Unlike other provinces, Quebec has chosen not to adopt reciprocal billing arrangements with other jurisdictions for most health services.

That means Quebecers traveling outside the province must prepay for their medical care and submit those costs to Quebec's public health insurance board, which may not fully reimburse them. Residents of other provinces who require medical services while in Quebec will also have to pay a co-payment.

In 2024, Quebec residents submitted $12.6 million in expenses to the Health Insurance Commission for services provided by professionals in other Canadian provinces, according to data obtained by The Canadian Press through a Freedom of Information request. Of this amount, the board repaid only $2.3 million.

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“As Quebec does not have reciprocal billing agreements for health services with other provinces, Quebec residents typically pay out-of-pocket for these services and are then reimbursed based on 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 rates between states can be large. Quebec's health department says it encourages people to purchase private health insurance when traveling outside the province.

Charles Shaver, a retired physician in Ottawa, said his practice has a policy of not seeing out-of-province patients who can't or won't pay for treatment. He said doctors and private practices in eastern Ontario often charge Quebec patients at rates set by the Ontario Medical Association, which are higher than the rates set by the government-run Ontario Health Insurance Plan.

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“It's not a good situation,” he said.

Doctors in other provinces can choose to bill Quebec patients directly or send their fees to the Quebec Health Insurance Commission for reimbursement. However, insurance boards usually do not provide full compensation.

In 2024, the Quebec Health Insurance Commission was billed $8.9 million by professionals outside Quebec, and was reimbursed only $7 million.

Under the Canada Health Act, provinces and territories must cover the cost of emergency medical and hospital services when their residents are temporarily out of province.

Quebec has entered into hospital insurance reciprocal billing agreements with the provinces and territories, which allow Quebec residents to receive hospital care anywhere in Canada without having to pay for medical care.

However, the Ministry of Health said it has no plans to enter into cross-billing agreements for other medical services.

© 2025 The Canadian Press