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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 higherOpens a new website in a new window - Opens in a new window  (not your browser) and save. Complete the plan member section.

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.

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