Coverage of dental services
http://www.ramq.gouv.qc.ca/fr/citoyens/assurance-maladie/soins/Pages/services-dentaires.aspx
Certain services rendered by dentists and denturologists are paid by the Régie de l’assurance maladie du Québec. Services are covered for all. Others are only for children under 10 years of age and recipients of last-resort financial assistance for a specified period.
For everyone
In hospitals, all insured persons are entitled to certain oral surgery services in case of trauma or illness. They are provided free of charge upon presentation of a valid health insurance card.
Here are some examples:
- Drainage of an abscess;
- Removal of a cyst or tumor;
- Reduction of a fracture.
Examinations, local or general anesthesia and related x-rays are also covered.
EXCLUSION
The costs related to the extraction of teeth and roots are not borne by the Régie.
For children under 10 years
In dental clinics or hospitals, upon presentation of their valid health insurance card, children under 10 receive free of charge the following services:
- annual review;
- emergency examinations;
- X-rays (including panoramic X-ray)
- local or general anesthesia;
- amalgam fillings (gray) for posterior teeth;
- fillings made of aesthetic material (white) for teeth
- earlier;
- prefabricated crowns;
- endodontics (including root canal treatment, apexification, pulpectomy, pulpotomy, emergency opening of the pulp chamber and sedative dressings);
- extraction of teeth and roots;
- Oral surgery services covered for all.
EXCLUSIONS
The costs of cleaning, descaling, applying fluoride and sealing wells and cracks are not paid by the Régie for children under 10 years of age.
For recipients of last resort financial assistance and their dependents
The Ministry of Labor, Employment and Social Solidarity determines the conditions giving entitlement to the services covered. You should refer to your local employment center for all the information on the subject. To benefit from the covered services, you must present your valid health insurance card and personal or family claim book.
PROVIDERS FOR AT LEAST 12 CONSECUTIVE MONTHS
Providers for at least 12 months and their dependents are entitled to the same services as those for children under 10 years of age. The only exceptions are root canal treatment and apexification, which are only covered for children under 13 years of age.
In addition to the services covered:
- cleaning and teaching hygiene measures, from 12 years;
- the application of fluoride, from 12 to 15 years inclusive;
- descaling, from 16 years old.
In case of emergency only, some services may be provided free of charge to recipients of last resort financial assistance for less than 12 months.
PROVIDERS FOR AT LEAST 24 CONSECUTIVE MONTHS
In addition to the other services, the cover includes, every 8 years, a lower prosthesis and a superior acrylic prosthesis. The Régie also pays:
- reline every 5 years;
- half of the cost of replacing lost or damaged prostheses;
- replacement of prostheses following surgery.
To be eligible for coverage of previous services, you must obtain written permission from a local employment center and submit it to the dentist or denturologist.
These services are also provided without charge:
- repair of prostheses;
- adding a structure.
- Removable partial dental prosthesis costs with metal skeleton are not assumed by the Régie.
SERVICES NON COVERED
Remain at the patient’s expense, regardless of age, condition and the place of performance, the following services:
- orthodontics (“pin” placement, palatal expansion, space maintainer, etc.);
- apectomy;
- periodontics (root planing, gingival grafts, periodontal surgeries, etc.);
- rectification and crowns other than prefabricated;
- bleaching;
- facets;
- dental implants;
- sealants wells and cracks.
Be sure that :
- the dentist accepts the health insurance card. Indeed, some do not participate in the health insurance plan. The services presented here remain, in this case, at your expense and can not be reimbursed by the Régie;
- your health insurance card is valid. Otherwise, you will have to pay the dentist and then ask the Régie for a refund.
FOR MORE INFORMATION
We invite you to visit our website.
www.ramq.gouv.qc.ca
You can also obtain information by phone
Québec : 418 646-4636
Montréal : 514 864-3411
Elsewhere in Québec : 1 800 561-9749
By mail
Régie de l’assurance maladie du Québec
PO Box 6600
Quebec City (Quebec) G1K 7T3
Our opening hours
Monday, Tuesday, Thursday and Friday: 8:30 am to 4:30 pm
Wednesday: 10 am to 4:30 pm
Outside business hours, phone numbers give you access to an automated information system.
