Health Care

(Collectif Bienvenue, 2023h, 2023h; Gouvernement du Québec, 2022a; Jobin-Théberge & Bombardier, 2020b; MSSSMinistère de la Santé et des Services sociaux , 2018; Services juridiques de Pointe-Saint-Charles et Petite-Bourgogne, 2017; TCRITable de concertation des organismes au service des personnes réfugiées et immigrantes , 2021; Ville de Sherbrooke, 2023e)

In Québec, the health care system is public and most care is available free of charge. Health professionals are well trained and the care is of good quality. However, there are sometimes long wait times to get some types of care, such as non-urgent surgery. This is true for everyone, including Canadian citizens.

• Nurses have a wealth of knowledge and can offer a wide range of treatments. Some nurses can prescribe medication and refer you to specialists.
• Pharmacists have a wealth of knowledge and can offer you a pharmacy consultation. 
• It can be difficult to get an appointment at a clinic. See RAMQ IFHP to find out how to make an appointment. 
• If you are unable to make an appointment at a clinic, don’t hesitate to talk to your friends, counsellors, etc. These people can share ideas or other options to help you see the right health professional.
• You will not have a family doctor when you arrive in Canada. You must register on a waiting list: Québec Family Doctor Finder The wait times are several years. As a refugee claimant, you are not entitled to a family doctor.

• Access to care: Your medical results will not influence your immigration status or your access to the care and services you need. For example, people living with HIVHuman immunodeficiency virus or hepatitis C are protected from discrimination in Québec. They have access to the necessary health services.
• Duty of confidentiality: Because of their duty to keep your personal information confidential, employees of the health and social services network are not allowed to share information about your health without your authorization, regardless of their job title. See Confidentiality in the Read This Information First section for more details.
• Access to an interpreter: If you do not speak English or French, the health institution can provide an interpreter. If possible, let the institution know in advance that you would like an interpreter. See Interpreters in the Read This Information First section for more details.
• Consent to care for people aged 14 and over: From the age of 14, young people can make their own appointments and attend medical consultations on their own. Young people can generally consent to care by themselves (including contraception). A person aged 14 or over can therefore ask to be alone (without the presence or the consent of their parents or guardian) when seeing a nurse, doctor or counsellor, for example, and can make their own decisions about their health care. 
• Abortion: Abortion is available and legal in Québec.

The Québec health care system works on referrals, prescriptions and renewals:

Every time you want to receive care, you must present:

• Your health insurance card Your Refugee Protection Claimant Document (brown paper) or your Acknowledgement of Claim
• Your vaccination record, if you have one
• Your claim slip (“blue slip”), if you receive social assistance
• Your private health insurance information, if any

To get an appointment at a CLSCLocal community service centre or medical clinic:

(CERDACentre d’expertise sur le bien-être et l’état de santé physique des réfugiés et des demandeurs d’asile et al., 2023; Collectif Bienvenue, 2023h; Croix Bleue Medavie, 2016; IRCCImmigration, Refugees and Citizenship Canada , 2017c, 2023o; Jobin-Théberge & Bombardier, 2020b; TCRITable de concertation des organismes au service des personnes réfugiées et immigrantes , 2021; Trosseille et al., 2019)

When you arrive in Québec, you must wait to receive your health insurance card before being covered by the RAMQRégie de l’assurance maladie du Québec . During this period, you are covered by another type of coverage called the IFHPInterim Federal Health Program .

Once you have received your RAMQRégie de l’assurance maladie du Québec health insurance card, and during your first year in Québec, you will still be covered by the IFHPInterim Federal Health Program for other services. You have access to certain additional services thanks to the IFHPInterim Federal Health Program , for example a psychologist, a physiotherapist, a dentist, an optometrist and mobility aids.

You will receive an IFHPInterim Federal Health Program eligibility document when you arrive at the airport. If you do not receive it, follow these instructions: Guide 5568 – Application for Interim Federal Health Program Coverage (IFHP) – Canada.ca.

Your host organization or sponsorship group will help you find specialists that accept the IFHPInterim Federal Health Program . If you are unable to find one, you may have to go to private clinics that do not accept the IFHPInterim Federal Health Program and pay for some types of care yourself.

As a refugee claimant, you are covered by the IFHPInterim Federal Health Program throughout the refugee claim process. You can use your Refugee Protection Claimant Document or your Acknowledgement of Claim to have these services covered.

You are not covered by the RAMQRégie de l’assurance maladie du Québec , which is the public health insurance plan for most people in Québec. 

Only health professionals registered as IFHPInterim Federal Health Program providers with Medavie Blue Cross can provide you with free or low-cost services. Health professionals who are not registered have the right to refuse you care or charge you for costs. A small minority of clinics and some CLSCLocal community service centre accept the IFHPInterim Federal Health Program .

The IFHPInterim Federal Health Program is not always well understood by health professionals. You may have to explain what the IFHPInterim Federal Health Program is in some places and insist on receiving care. However, hospital emergency rooms are required to provide care.

If you have just arrived and have not received your health insurance card yet, follow these steps:

1. Consult a doctor or nurse for a prescription.
2. If you have a prescription for a drug or a refill, pick it up at a pharmacy.
3. Find a pharmacy that accepts the IFHPInterim Federal Health Program . It is best to call ahead to check. Go to the pharmacy between 9 a.m. and 4 p.m., as the pharmacy will need to contact Medavie Blue Cross.
4. Bring the following documents with you:

• Your prescription
• Your Refugee Protection Claimant Document or your Acknowledgement of Claim, mentioning that you are covered by the IFHPInterim Federal Health Program
• Your IFHPInterim Federal Health Program eligibility document

5. The vast majority of prescription drugs are covered. Your pharmacist can confirm whether your prescribed medication is covered.
   If the drug is not covered by the IFHPInterim Federal Health Program , the pharmacist can sometimes offer an equivalent drug. Otherwise, you will have to pay for the prescribed medication.
6. If the drug is covered by the IFHPInterim Federal Health Program :

(Croix Bleue Medavie, 2022; Régie de l’assurance maladie, s. d.-d)

This table is inspired by and adapted from the CERDACentre d’expertise sur le bien-être et l’état de santé physique des réfugiés et des demandeurs d’asile infographic “The IFHPInterim Federal Health Program : Important to Know,” CERDA: The IFHP: Important to Know

(CERDACentre d’expertise sur le bien-être et l’état de santé physique des réfugiés et des demandeurs d’asile , 2022; Cleveland, Hanley, Salamanca Cardona, Manuel, et al., 2021; Trosseille et al., 2019)

Many people arriving in Québec face major challenges. It is normal for the many difficulties associated with your migration experience (fleeing your home country, waiting and adjusting to a new one) to affect you. You may feel sad, stressed, distressed, depressed, tired, etc. You may also experience challenging things such as uncertainty, feeling like you are losing your connection to your culture of origin, loneliness, lower self-esteem, anger, etc. 

If these challenges are familiar to you, keep in mind that other people also experience these emotions and difficulties when they arrive in Québec. It is normal to react to obstacles and changes, experience challenging emotions and have negative thoughts after these events. Help is available.

If you feel the need to receive assistance and talk to someone about it, you can make an appointment with a professional. Just like there are physical health professionals, there are also professionals who specialize in mental health and well-being (ex., psychologists, social workers, psychoeducators, therapists, psychiatrists, etc.). Community organizations and your sponsorship group can help you obtain support services. 

Community support groups are also available. You can also be accompanied to a doctor and/or CLSCLocal community service centre to get a referral or specialized care. The IFHPInterim Federal Health Program covers the first 10 one-hour psychotherapy sessions. You will then need to get a new referral from a doctor to extend this and your psychologist or psychotherapist will need to ask Medavie Blue Cross for authorization.

Some types of care may be offered in the private sector. Make sure the professional accepts IFHPInterim Federal Health Program coverage or your private coverage.

(AGIR Montréal, 2023; Collectif Bienvenue, 2023h; Éducaloi, 2023j; Rainbow Response Coalition et al., 2012)

For additional information and exercises on many aspects of this Carnets de route section, see chapter “Health”, pages 93 to 106, in the Canadian Orientation Abroad “Participant’s Workbook”.

You can also listen to the audio guide “O Canada – Conversations Dialogue” and download the application “O Canada”.