The starting point. Quebec's health insurance is run by the Régie de l'assurance maladie du Québec (RAMQ). It covers much of your medical care, but you're not enrolled automatically when you arrive: you have to apply yourself, and the sooner the better.
The waiting period. When you register, your coverage usually begins after a maximum of 3 months. The waiting period starts on the date you register, provided you are in Quebec and have all the required documents in hand; if a document is missing, you have 12 months to send it, otherwise the start of your coverage is delayed. It applies even if you're a Canadian citizen.
Who is exempt. The waiting period does not apply to children under 18. RAMQ also grants health insurance from registration to people arriving from one of the 11 countries with a social security agreement with Quebec (including France and Belgium, on presentation of a certificate from their country), refugees and protected persons, Canadians repatriated by the government, recipients of last-resort financial assistance, certain Quebec government fellowship recipients and certain seasonal agricultural workers. Pregnant women are not exempt, but care related to pregnancy and childbirth remains free during the waiting period.
Protecting yourself during the wait. While the waiting period runs, you are not covered by RAMQ and care can be expensive. It's strongly advised to take out private health insurance for this stretch so you're never left without protection.
Registering. In most cases you can register online; in certain situations you'll need to call RAMQ at 1-800-561-9749. Prepare your documents according to your status (permanent residence, work permit, and so on), have your photo taken when required, and your card will then be mailed to you.
Renewing. The card has an expiry date. Permanent residents usually receive a renewal notice a few months before it lapses; temporary residents often have to start the process themselves without an automatic notice. Don't let your card expire: a lapsed card can force you to pay for care that's normally covered.
Good to know for newcomers. Register with RAMQ in your very first days in Quebec — the waiting period starts on the date you register (if you have all your documents), so every week counts. And keep private insurance until your public coverage actually begins.
