Proton therapy funding in Quebec

If you live in Quebec, the Régie de l’assurance maladie du Québec (RAMQ) may pay for proton therapy outside Canada. The treatment must be medically necessary and authorised in advance. This page is in English for convenience. RAMQ’s own documents are in French, and the French version is the one that governs. RAMQ, not this site, decides your case.

What this page covers

Your plan and who applies for you.
The two-specialist request and the benefit assessment.
The steps, and how to ask for a review if you are declined.

Your plan at a glance

Plan: Régie de l’assurance maladie du Québec (RAMQ).
Who applies: two specialist physicians in the field related to your illness must sign the request. You cannot apply for yourself.
Approval before travel: required. Insured services outside Quebec must be authorised in advance by RAMQ.
Language: RAMQ documents are in French, and the French version prevails. English pages and forms are provided for convenience.

How out-of-country funding works in Quebec

RAMQ can reimburse insured services provided outside Quebec, under the Health Insurance Act and its regulation. For care planned outside Canada, the regulation requires that the service be authorised beforehand by RAMQ. The written request must be signed by two physicians who specialise in the field related to the illness.

For planned care outside Canada, hospital expenses are not reimbursed. Only doctors’ fees may be reimbursed, based on the rates in force in Quebec. Travel, accommodation, and meals are not reimbursed, because they are not insured services.

Step by step

Speak with your specialists about whether proton therapy may suit your case.
Two specialists in the relevant field sign and submit the pre-authorisation request to RAMQ before any treatment is booked.
Wait for RAMQ’s decision.
If authorised, arrange treatment with your team, keeping records for reimbursement of doctors’ fees.
If declined, use the review route below within its deadline.

Important: who decides

RAMQ decides whether your treatment abroad is authorised and reimbursed. Do not book or start treatment before you have authorisation, or you may have to pay the full cost yourself.

If you are declined

If you are declined, you can submit an application for review to RAMQ within six months of being notified. After that, you can seek recourse at the Tribunal administratif du Québec. Approval on review is very rare, however. The effort is better spent on a complete, well-documented first application prepared with your specialists.

Proton therapy referral in Quebec

Quebec’s proton therapy referral program requires an assessment of the potential benefit of proton therapy over standard (photon) radiation before approval. RAMQ reimburses out-of-country proton therapy only for specific clinical indications, after an expert-committee review. Re-irradiation and metastatic disease are not excluded from consideration. Eligibility includes an expected survival of more than five years. As part of approval, an assessment comparing a proton plan with a standard radiation plan is prepared by treating teams. This matches a pan-Canadian consensus that provinces require expert case review to confirm proton therapy is suitable before funding it. Your specialists lead this assessment.

Frequently asked questions

Does RAMQ cover proton therapy?

It may. Canada has no operating proton therapy centre today. So a medically necessary case can meet the test that the treatment is not available here. Two specialists in the field related to your illness sign the request, and RAMQ decides.

How long does a RAMQ decision take?

RAMQ does not publish a decision time for out-of-country requests. Your specialists can ask RAMQ for current timing when applying.

Sources for this page (6)

Healthcare received outside Canada, doctors’ fees only at Quebec rates: RAMQ. ramq.gouv.qc.ca (checked 2026-07-06)
Legal basis and two-specialist prior-authorisation requirement: Health Insurance Act, CQLR c. A-29, and Regulation A-29, r. 5, s. 23.1. canlii.org ; canlii.org (checked 2026-07-06)
Review by RAMQ within six months, then Tribunal administratif du Québec: RAMQ. ramq.gouv.qc.ca ; taq.gouv.qc.ca (checked 2026-07-06)
Quebec proton program requires a benefit assessment over photon therapy and expert review: pan-Canadian consensus, Radiotherapy and Oncology, 2021, PubMed 36228758. pubmed.ncbi.nlm.nih.gov (checked 2026-07-06)
Re-irradiation and metastatic disease are not excluded, and eligibility includes an expected survival of more than five years: Tsang et al., Proton Therapy in Canada, Red Journal, 2022, S0360-3016(22)03642-2. redjournal.org (checked 2026-07-06)
Note: the exact pre-authorisation form number and the verbatim French-prevails disclaimer were not confirmed from an accessible government page. Verify directly with RAMQ at ramq.gouv.qc.ca

Every statement on this page is drawn from the sources listed below. Last updated: 15 July 2026.

This page is for general education only. It is not medical advice and it is not a decision about your care or your funding. Only your treating physician can advise you on treatment. Only your provincial or territorial health plan can decide whether it will fund treatment outside the country. protontherapy.ca is an information resource by Maple Med Global (MMG Medical Tourism Inc.), Toronto, Canada. We are not a hospital, a clinic, or a government body, and we do not provide medical care.