Access to medical services in Ontario

Only citizens with a residential address in Témiscaming, Kipawa or Kebaowek and holding a valid RAMQ card are eligible for this measure.

No. You must complete the Ontario Doctor Consultation Request Form for each new follow-up appointment or diagnostic test you require in Ontario. When you wish to consult a doctor in a new medical specialty, you must complete the form for your first appointment. You do not need to complete the form for each subsequent follow-up appointment you have with that same specialty.

No. Several doctors in Ontario provide medical services to Quebec citizens by adopting practices that comply with current interprovincial agreements.

Doctors in Ontario can send their claim forms directly to the Régie de l'assurance maladie du Québec (RAMQ) or bill their patients for the full cost of the service provided or for the portion of the cost corresponding to the difference in fees between Quebec and Ontario. A Quebec resident insured with RAMQ can submit a claim to RAMQ for medical services received in Ontario.

The Canada Health Act stipulates that urgent health services are always available to Canadian citizens, regardless of their province of residence; this is a legal obligation for each province. You may subsequently receive a bill for medical fees. However, all hospital costs are covered by the Ontario facility providing your services, which will then be reimbursed directly by the RAMQ (Quebec Health Insurance Plan). This includes hospitalization costs.

For elective (non-urgent) services, the doctor alone decides whether to provide care or medical services to a Quebec resident. When the doctor agrees to provide medical services, they may bill you directly or claim reimbursement from RAMQ. If you pay part or all of the fees directly, you can then submit a reimbursement claim to RAMQ. There may be a difference between the amount claimed and the amount reimbursed by RAMQ. This difference could be covered by private insurance.

• Check with your treating doctor in Ontario if they agree to have their billing sent directly to RAMQ by completing the professional fees claim form for services provided to citizens outside the province;
• If your treating doctor decides to bill you directly for their fees, you can check with your private insurance coverage to see if the difference in fees for medical services received is covered;
• Your treating doctor in Ontario can also, at their discretion, adjust their fees to what RAMQ will reimburse you;
• Consult a healthcare professional in Abitibi-Témiscamingue at the various facilities of the CISSS de l'Abitibi-Témiscamingue. Some services are offered via telehealth, therefore without requiring travel, from the Centre multiservices de santé et de services sociaux de Témiscaming-Kipawa.

For non-urgent services, Ontario doctors are not obligated to serve residents of other provinces. The College of Doctors and Surgeons of Ontario sets out the procedures for ending a patient relationship. These procedures stipulate that a doctor must explain the termination of care to the patient and the reasons for it, ensure any necessary follow-up if tests are pending, and address any urgent needs while awaiting care from another doctor. Furthermore, the doctor must make the relevant medical records available to facilitate the continuation of care by another doctor.

Specialized medical services are available throughout the Abitibi-Témiscamingue region. Having to travel to a facility within the region to receive medical care can be a challenge for some residents.

A financial assistance program is available to users of the Abitibi-Témiscamingue health and social services network who must travel outside the region, at the request of their doctor, to receive health and social services not available in Abitibi-Témiscamingue. Certain trips within the region to access health services are also covered by the financial assistance program.

The User Travel Policy stems from the Quebec Health and Social Services Network's User Travel Policy. It offers financial assistance to individuals, but does not cover all travel and accommodation expenses. The Centre intégré de santé et de services sociaux (CISSS) de l’Abitibi-Témiscamingue implements the ministerial directive as the Quebec Health and Social Services Network's User Travel Policy, in accordance with the User Travel Procedure derived from the Health and Social Services Network Policy . It should be noted that individuals who choose to receive services in Ontario are not eligible for the User Travel Policy.

Also, the CISSS de l’Abitibi-Témiscamingue is committed to continuing the deployment of telehealth services in order to limit the travel required to receive a service.

Reciprocal remuneration agreements between Canadian provinces regarding medical services are the responsibility of the provincial governments. Quebec has not signed any such agreements concerning the remuneration of medical services. The CISSS de l'Abitibi-Témiscamingue does not have the authority or jurisdiction to conclude such agreements regarding doctor billing and remuneration.

Quebec has joined health insurance agreements concerning hospital services, ensuring coverage of hospital services offered in another province for Quebec citizens without these citizens having to assume costs.

The doctor or clinic consulted in Ontario will be able to confirm whether the digital version that was emailed to you is suitable or ask you for a printed version of the letter received.

Several factors can influence a doctor's decision in Ontario to accept or decline to provide medical services to Quebec residents, including the salary gap between Quebec and Ontario, the ability to provide services in a context of limited medical staff, and the challenges encountered when information from residents' medical records must be exchanged between clinical teams in Quebec and Ontario when residents receive health services in both regions. The transitional arrangement put in place provides a temporary solution to the salary gap issue.

Every citizen wishing to access medical services in Ontario and eligible for the transitional arrangement receives a personalized official document confirming their eligibility for this arrangement, designed to facilitate access to medical services in Ontario. This document can be presented to the doctor in Ontario from whom medical services are requested. Each doctor concerned is thus informed of the CISSS de l'Abitibi-Témiscamingue's offer of support in managing claims for professional fees for medical services rendered and in compensating for the difference in rates between those in Quebec and Ontario. Individualized management is prioritized to ensure personalized communication with doctors in Ontario.

Furthermore, several doctors in Ontario provide medical services to Quebec residents living in the southern part of Témiscamingue, other areas of Abitibi-Témiscamingue, or other regions of Quebec bordering Ontario. Various billing practices are possible. The doctor can claim their professional fees directly from the Régie de l'assurance maladie du Québec (RAMQ), bill the resident in whole or in part, or adjust their fees for Quebec residents. A Quebec resident covered by RAMQ can request reimbursement from RAMQ after incurring medical expenses for services received outside the province.

The CISSS de l’Abitibi-Témiscamingue will contribute to the work of the working committee announced by the government, which will bring together the relevant partners, with the objective of facilitating access to local health services for the population of the southern sector of Témiscamingue and defining a sustainable solution.

Individuals who are dissatisfied can contact the Complaints and Service Quality Commissioner .

It should be noted that the complaint may not be processed under the complaints review system, as the mandate of the Regional Complaints and Service Quality Commissioner concerns the handling of dissatisfaction related to the quality of care and services offered by the CISSS de l’Abitibi-Témiscamingue. Anyone filing a complaint will receive a written response after submitting it.