Change to the out-of-pocket maximum in Quebec

July 09, 2026

The Régie de l’assurance maladie du Québec (RAMQ) announced a change to the Quebec drug insurance plan. This change affects plan sponsors who provide drug coverage to plan members residing in Quebec.

Out-of pocket-maximum (effective July 1, 2026). RAMQ has increased the out-of-pocket maximum payable for plan members residing in Quebec, for drugs listed on the RAMQ formulary.  There is no change to the minimum co-insurance amount, it remains 70%. 

Out-of-pocket maximum

The change below was effective July 1, 2026.

Legislative changes

Drug claims for Quebec plan members

Increase in annual out-of-pocket maximum to $1263 from $1232.

Drug claims for plan members residing in Quebec for drugs listed on the RAMQ formulary are subject to the new annual out-of-pocket maximum of $1263.

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

Questions? We’re here to help.

Please contact your Sun Life Group Benefits representative.