Quebecers paid more than $10 million out of pocket to get healthcare in other provinces last year.
Unlike other provinces, Quebec has chosen not to enter into cross-billing agreements with other jurisdictions for most health care services.
This means that Quebec residents traveling outside the province must pay for health care in advance and then report their costs to Quebec's public health insurance board, which may not fully reimburse the costs. Residents of other provinces who require medical services while in Quebec must also pay out of pocket.
Data obtained by The Canadian Press through an access to information request shows that Quebec residents submitted $12.6 million in charges to the health insurance board in 2024 for services provided by professionals in other Canadian provinces. Of that amount, the council only reimbursed $2.3 million.
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“Because Quebec does not have reciprocal billing agreements for health care services with other provinces, Quebec residents typically pay for these services out of pocket and are then reimbursed at 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 provinces can be significant. Quebec's health department says it encourages people to take out private health insurance for any travel outside the province.
Charles Shaver, a retired internist from Ottawa, said his clinic has a policy of not accepting patients from other provinces who can't or won't pay for treatment. He said doctors and private clinics in eastern Ontario often bill Quebec patients at rates set by the Ontario Medical Association that are higher than those set by the government-run Ontario Health Insurance Plan.
“It's not a good situation,” he said.
Doctors in other provinces can bill Quebec patients directly or send payments to the Quebec Health Insurance Council for reimbursement. But the insurance commission, as a rule, does not reimburse them in full.
In 2024, the Quebec health insurance board was billed $8.9 million by providers outside Quebec and only reimbursed $7 million.
Under the Canada Health Act, provinces and territories are required to cover the costs of emergency medical care and hospital services for their residents when they are temporarily outside their province.
Quebec has signed hospital insurance reciprocal billing agreements with each province and territory, allowing Quebecers to receive hospital care anywhere in Canada without having to pay for it.
However, the health department said it has no plans to sign cross-billing agreements for other health care services.
© 2025 The Canadian Press
