Quebec Exceptional Medications and Exception Patient Program Forms
Have coverage through your employer or plan sponsor? You’re in the right place.
If you bought coverage through your advisor, you may be eligible for coverage under RAMQ’s Public Prescription Drug Insurance Plan. Please contact your doctor to apply for the Exceptional Medications and Exception Patient Program.
Request pre-approval
Use this form to request approval for prescription drugs under the Quebec Exceptional Medications and Exception Patient Program.
Step 1: Complete a form.
Download the form and print it, or fill it out in Adobe Reader XI or higher - Opens in a new window (not your browser) and save. Complete the plan member section.
For Quebec residents only. If you have coverage through your employer or plan sponsor, use this form to request approval for coverage for a drug listed in RAMQ’s List of Medications. You’ll need the doctor to fill in some sections.
For Quebec residents only. If you have coverage through your employer or plan sponsor, use this form to request approval for a drug not listed in RAMQ’s List of Medications. You’ll need the doctor to fill in some sections.
Step 2: Ask your doctor to complete the physician information section.
Step 3: Submit your request for approval.
You’ll find instructions on how to submit your claim on the form itself.