Ostomy Supply Reimbursement in Quebec

Ostomy Appliances Program (OAP)

The Ostomy Appliances Program(OAP) provides financial support for purchasing or replacing ostomy supplies. The financial assistance is paid out once per year. The amount is determined according to the type of stoma: permanent or temporary.

Am I Eligible?

To qualify for the program, you must meet the following two conditions:

You must notify us without delay of the closure of your stoma or a change in your physical condition. You can do so in writing or over the phone.

Benefits Coverage

For each ostomy, the program provides for an annual lump-sum payment of:

$1,298 for a permanent ostomy
$865 for a temporary ostomy

The amount granted is intended to purchase your supplies (bags and other products) and their replacement. You have to pay the over cost if the amount of your invoice exceeds the lump-sum amount granted under the program. The portion you pay can be claimed to a third-party insurance program or claimed as a Medical Expense on your income tax.

How to Apply for OAP Benefits

You must carry out the three following steps for each ostomy as part of your 1st application for registration. If necessary, we may request other documents essential for assessing your application.

Complete and print the application form for OAP
Obtain a medical prescription
Mail the completed form and medical prescription to OAP (see Contact Info)

It is recommended that you keep copies of the documents that you send.

The medical prescription must contain the following legible information:

Your first and last names
Your date of birth or Health Insurance Number
The date and type of surgery (colostomy, ileostomy or urostomy)
Confirmation of the permanent or temporary character of the ostomy
The first and last names and the permit number of the physician
The date of the prescription
The physician's signature

Reimbursement Procedure

After registering with the program, you will automatically receive the lump-sum payment granted to purchase and replace your appliances. We will mail the amount to the address on file for you. For this reason, remember to notify us if you move.

The processing time is 60 days. We will contact you if your application is incomplete. In any case, you will not receive an acknowledgement of receipt. Please call us only if the processing time is exceeded.

Claim Slip (Carnet De Réclamation)

The purchase and replacement of ostomy appliances are fully reimbursed under the program if you hold a valid claim slip (carnet de réclamation). To qualify, you must be registered with the Ministère du Travail, del’Emploi et de la Solidarité sociale and send us your detailed invoices, along with proof of payment, within 12 months following the date of purchase.

In this regard, an agreement may be concluded voluntarily so that we pay the actual cost of the appliances directly to the provider. You can discuss the matter with the provider of your choice and then contact us to conclude the agreement, if applicable. Signing this agreement will terminate the automatic payment of all lump-sum payments.

Contents Of Your Detailed Invoices

Any detailed invoice must contain the following information:

The name, address and telephone number of the business where the appliance was purchased
The date of purchase
A description of the appliance and its price
Your first and last names

Please see the following document for more information on the Ostomy Appliances Program: https://www.ramq.gouv.qc.ca/sites/default/files/documents/depl-appareils-stomises-permanents-en.pdf

Contact Information:

RÉGIE DE L'ASSURANCE MALADIE DU QUÉBEC

C.P. 6600, succ.,
Terminus Quebec QC G1K 7T3

Québec: 418-646-4636
Montréal: 514-864-3411
Elsewhere in Québec: 1-800-561-9749

Disclaimer: The information contained in this page have been researched and sourced from a variety of provincial and federal sites. However information may change and we encourage individuals to check for updates of policies, plans and forms.

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