Quebec RAMQ Breast Prosthesis Coverage: A Complete Guide

If you live in Quebec and have had a mastectomy, RAMQ may reimburse a significant portion of the cost of your external breast form - up to $536 per breast.

Quebec's External Breastforms Program, administered by the Régie de l'assurance maladie du Québec (RAMQ), is one of the most generous breast prosthesis programs in Canada. This guide explains who qualifies, how much you can receive, the one eligibility rule that surprises many people, and how to apply.

🍁 Important if you're shopping with us: To be reimbursed by RAMQ, your breast form must be purchased from a business established in Québec. Naturally You Boutique is located in Barrie, Ontario, so a breast form purchased from us is not eligible for RAMQ reimbursement.

We can still help Quebec residents in two important ways: through private or extended health insurance (which does not have a Quebec-business requirement), and with expert virtual fittings and product guidance. If RAMQ reimbursement is your priority for the breast form itself, purchase it from a Quebec-based supplier - and feel free to contact us for help with bras, accessories, and your private insurance claim.

Who Qualifies for the RAMQ External Breastforms Program?

To qualify, you must be covered by the Québec Health Insurance Plan and be in one of these situations:

You have undergone a total, radical, or partial mastectomy; or
You are aged 14 or over and have received a diagnosis of breast aplasia (total absence of breast formation).

How Much Does RAMQ Cover?

For each breast, per 24-month period, RAMQ reimburses the purchase or replacement cost of an external breast form (regular or swim) up to a maximum of:

$536 for a full breast form
$316 for a partial breast form

If your invoice is higher than the maximum, RAMQ will not reimburse the difference - but your private insurance may cover it, so it's worth checking with your insurer. These amounts are indexed each year on January 1.

New as of late 2025: RAMQ now also covers swim breast forms (for purchases made after November 9, 2025), in addition to regular forms.

The One Rule That Surprises People: "Established in Québec"

RAMQ will only reimburse breast forms purchased from a business established in Québec. This requirement exists to ensure you're properly fitted and buying medical-grade products. It also means that even an excellent, certified boutique located outside Quebec cannot be used for a RAMQ claim.

If RAMQ reimbursement matters most to you, purchase your breast form from a Quebec-based, RAMQ-recognized supplier. You can still use private or extended insurance for purchases made elsewhere, including with us.

How to Apply for RAMQ Reimbursement

You apply online through RAMQ after you've purchased your breast form. See the official RAMQ External Breastforms page.

You'll need to provide:

Your identity and contact information
Your Health Insurance Number
The reason for your application (type and date of surgery, or date of diagnosis)
Information about the breast form (side, type, description)
The purchase amount before taxes and the date of purchase
The name and QST number of the business (if the QST number isn't on your invoice, ask the business for it)

Keep your detailed invoice, proof of payment, and any medical report or prescription for at least 5 years, as RAMQ may re-examine your application. The usual processing time is about 50 working days.

Combining RAMQ With Private Insurance

Many Quebec residents use RAMQ for the breast form (up to the maximum) and then claim remaining costs - such as the balance above the maximum, plus mastectomy bras - through private or extended health insurance. Mastectomy bras are generally not part of the RAMQ program, so private coverage is usually how they're reimbursed.

To claim through private insurance, you'll typically need a prescription from your doctor or surgeon for an "external breast prosthesis" and/or "post-mastectomy bras," plus a detailed receipt. We provide itemized receipts and can guide you through the private-insurance side of your claim.

Frequently Asked Questions

How much does RAMQ pay for a breast form?
Up to $536 for a full breast form and $316 for a partial form, per breast, per 24-month period, indexed annually.

Does RAMQ cover mastectomy bras?
The External Breastforms Program covers external breast forms (including swim forms), not bras. Mastectomy bras are usually covered by private or extended health insurance.

Can I claim RAMQ if I buy from a store outside Quebec?
No. RAMQ requires the breast form to be purchased from a business established in Québec. Purchases from outside Quebec can still be submitted to private insurance.

Does RAMQ cover swim breast forms?
Yes, as of purchases made after November 9, 2025, swim breast forms are included in the program.

Program rules and amounts are set by RAMQ and can change. Always confirm current details on the official RAMQ website if anything is unclear.

How We Can Help Quebec Residents

Even though a RAMQ claim must go through a Quebec supplier, our Amoena Certified Mastectomy Fitters can support you with a private virtual fitting, help you choose the right bras and accessories, and guide your private-insurance claim.

Book a Virtual Fitting Contact Us