RAMQ Premium 2026: How Quebec's Drug Insurance Premium Works

Every spring, a lot of Quebecers find a line on their tax return they weren’t expecting: line 447, the premium payable under the Québec prescription drug insurance plan. It’s the annual premium for the RAMQ’s public plan. Since July 1, 2026, it can reach $789 per adult, and it’s worked out on Schedule K from your net family income.

You pay it even if you never bought a prescription, because it’s an insurance premium. Quebec is the only province where everyone has to be covered by a prescription drug plan, the RAMQ (in French) (opens in a new tab) points out. If a group plan doesn’t cover you, the public plan does, and the bill comes with your taxes.

Who has to pay the RAMQ premium?

Anyone covered by the RAMQ’s public plan pays the premium, with a few exceptions. That mostly means people with no access to a group plan: the self-employed, employees with no insurance at work, people who’ve lost their job and retirees with no private plan. A group plan that covers prescription drugs all year means you don’t pay it.

Revenu Québec (opens in a new tab) sums up the rule by the kind of insurance you had:

The RAMQ doesn’t pay for ambulances, and supplemental insurance often does. In Quebec, an ambulance costs $125 plus $1.75 a kilometre, although most people 65 or older don’t pay.

Who’s covered for free

According to the RAMQ (opens in a new tab), some people are covered by the public plan without paying a premium:

• children of people covered by the public plan, if they have no access to a private plan: those under 18, and those 18 to 25 who are in school full time, have no spouse and live with their parents;
• people who hold a claim slip (carnet de réclamation), such as social assistance recipients;
• people 65 or older who get at least 94% of the maximum Guaranteed Income Supplement.

People with low incomes don’t pay either. For 2025, that meant a single person with net income of $19,890 or less, and a couple with combined net income of $32,240 or less. In all, about a third of the 3.9 million people covered by the public plan pay no premium, according to the RAMQ (in French) (opens in a new tab).

How much is the RAMQ premium in 2026?

The maximum premium is $789 per adult from July 1, 2026, to June 30, 2027, a 3% increase. Because the rate changes every July 1, the maximum on your return blends two rates: the first half of the year at the old one, the second half at the new one. For 2026, our math comes to $777.50.

Source: RAMQ (in French) (opens in a new tab), rate comparison table.

That blend is where the $755 maximum on the 2025 return, filed in spring 2026, comes from: six months at the $744 rate and six at the $766 rate, as Schedule K (opens in a new tab) shows. The same math with $766 and $789 gives $777.50 for the 2026 return you’ll file in spring 2027. Revenu Québec will confirm the figure in the 2026 Schedule K, which comes out with that year’s forms.

How is the premium calculated from your income?

Schedule K starts from your net income (line 275), plus your spouse’s if you had one on December 31. It subtracts an exemption amount that depends on your family situation, then applies a rate to what’s left, up to the maximum. A single person pays 7.84% on the first $5,000 above the exemption and 11.76% on the rest. For a couple the rates are 3.93% and 5.89%, but each spouse pays their own premium.

Source: 2025 Schedule K (opens in a new tab), Revenu Québec.

Here’s what that works out to for someone covered by the public plan for all 12 months:

Lodavo’s calculations using the 2025 Schedule K, rounded to the dollar. The 2026 thresholds will be a little higher, since they’re indexed every year.

You hit the maximum at a modest income

A single person pays the full premium from about $28,000 of net income. A couple with no children reaches the maximum at about $46,700 combined, and then pays $1,510 between them. So most people working full time without a group plan pay the maximum.

Take Julie, who’s single with no children and has net income of $25,000. Subtract $19,890 and $5,110 is left. She pays 7.84% on the first $5,000 ($392) and 11.76% on the next $110 ($12.94), for a premium of $404.94.

A partial year costs less

The premium is worked out by the month. If a group plan covered you from January to June and the public plan from July to December, you only pay for the six months on the public plan, which is about half the premium. You tick the months the group plan covered you in Part B of Schedule K.

What else do you pay at the pharmacy?

The premium is only part of the cost. At the pharmacy, the public plan also has you pay a deductible and co-insurance, up to a cap. These are the rates from July 1, 2026, to June 30, 2027, according to the RAMQ (opens in a new tab):

For a $60 prescription each month, you pay $32.88: the $21.25 deductible, plus 30% of the $38.75 left over. Someone who pays the maximum premium and hits the cap every month pays a little over $2,000 a year at these rates.

The cap matters most when a prescription is expensive. If Quebec’s program covers your IVF cycle, the fertility drugs go through this plan, so on the public plan you pay at most $105.25 a month for them. In provinces that don’t cover them, an IVF cycle’s drugs cost $3,000 to $10,000.

How do you avoid paying the premium for nothing?

You can’t opt out of being insured. But people do pay a premium they didn’t owe, or pay it without being covered. Check where you stand before you file.

A group plan covered you all year

You don’t fill in Schedule K, but you do have to say so. Enter 14 in box 449 if you were a member of the plan, or 16 if it was your spouse’s, your father’s or your mother’s plan, according to Revenu Québec’s line 447 instructions (opens in a new tab).

You turned down your employer’s group plan

If you could have joined a group plan that covers prescription drugs, you had to. If you didn’t, you still pay the public plan premium, and you’re not entitled to its benefits, Revenu Québec says. So you pay without being covered.

You got a group plan partway through the year

When you join a group plan at a new job, contact the RAMQ to cancel your public plan registration. On your return, tick the months the group plan covered you so you only pay for the rest.

You left Quebec

After a full calendar year outside Quebec, the public plan no longer covers you and you have no premium to pay. If you leave for less than a year, you pay the premium for the months you were in Quebec, according to the RAMQ (opens in a new tab).

An April bill you can get ready now

The premium is due all at once, right when you find out what you owe. At $789 a year, it’s $65.75 a month. Put that aside in a savings account each month and the premium is ready in April, instead of going on a credit card.

That’s the kind of saving Lodavo rewards. The app is free and connects to the account you already save in. Every $25 of your balance earns a ticket in the weekly draw, with prizes up to $10,000. Once you’ve built it up, the $789 for the premium earns you 31 tickets a week, right up until the day you pay the bill.

Lodavo is free on the Apple App Store (opens in a new tab) and the Google Play Store (opens in a new tab).

This article is general information, not tax advice. Your premium depends on your situation and your months of coverage, so the Schedule K on your return is what counts.

Terms and conditions apply. No purchase necessary (alternate method of entry available). Skill-testing question required. Open to legal residents of Canada who are the age of majority. Odds depend on the number of eligible entries received. Full rules and odds at our contest rules.