Changes to the out-of-pocket maximum and co-insurance amount in Quebec

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The Régie de l’assurance maladie du Québec (RAMQ) has made changes to the Quebec drug insurance plan. These changes affect plan sponsors who provide drug coverage to plan members residing in Quebec.

Out-of-pocket maximum and co-insurance (effective July 1, 2025). RAMQ has increased the annual out-of-pocket maximum payable by Quebec plan members for prescriptions drugs (to $1232 from $1196).  They have also increased the minimum co-insurance (amount RAMQ pays) from 68% to 70%. 

We’ve updated our systems to reflect these changes. There will be no immediate rate adjustments due to the changes. We expect minimal impact to plan members and on claim experience. 

We’ll be sending this Focus Update to plan sponsors on July 10, 2025.

Questions? We’re here to help.

Please contact your Sun Life Group Benefits representative.