Your “Savvy Retiree” Newsletter for November 2025
To facilitate the reading of the different articles, just click on one of the titles below
The consultation held this summer among members of the retirees’ group insurance plan achieved an excellent participation rate. Many of you took the time to complete the questionnaire and share your comments, reflecting your strong interest in your collective plan.
The results helped guide significant adjustments to the plan, both in terms of coverage and access to benefits. These adjustments aim to better meet the needs expressed by members while ensuring the plan’s sustainability for years to come.
For the moment, the proposed modifications must be approved by the Treasury Board, which is why we are not yet able to share the details.
However, we can assure you that the anticipated changes represent a positive evolution of the plan and should be well received by most members. Full details will be communicated no later than mid-December, at the time of the annual contract renewal and premium rate update.
A sincere thank-you for your participation, which made it possible to analyze the responses collected and propose concrete adjustments to help the collective plan evolve in line with the priorities expressed by its members.
First and foremost, it’s important to note that private group insurance plans follow the same procedures as the Régie de l’assurance maladie du Québec (RAMQ), which recently tightened the eligibility criteria for generic substitution exceptions.
As a reminder, generic drugs contain the same active ingredient as the original (brand-name) medications. Cases of intolerance or allergy to another substance contained in a generic drug remain rare. However, a certificate from a healthcare professional is required to obtain an exception, just as it is for individuals covered by the RAMQ.
The Generic Substitution Exception Form can be completed by any authorized prescribing professional.
Download the form from the Beneva website
In a context where many people do not have a family doctor, it can sometimes be difficult to know whom to contact to obtain this authorization. To help, INESSS has produced a reference guide listing the healthcare professionals authorized to prescribe medications, in addition to physicians, namely, specialized nurse practitioners.
Consult the INESSS reference guide
A real-life situation that could happen to anyone.
During a three-week organized tour, one of our members and their spouse unfortunately caught gastroenteritis in the second week. They had to isolate for several days before rejoining the planned group activities. Upon returning home, they submitted a claim to the insurer for the activities they missed.
The insurer denied the reimbursement. Why?
Even though illness is an eligible cause for trip interruption, the claimed expenses (missed activities) are not covered by the insurance contract. In the event of a temporary interruption of travel, the group insurance plan only provides reimbursement for the additional transportation ticket needed to rejoin the group or resume the planned itinerary, if medically justified.
Excerpt from the brochure - Article 3.6.2
“In the event of a trip interruption, covered expenses are limited to the cost of a one-way, economy-class ticket to reach the originally planned destination.”
In other words, if your health condition does not require you to return earlier or delay your return, expenses related to missed activities cannot be reimbursed.
An Important Reflex to Adopt
If you have a health issue, even a minor one, for which you might submit an expense claim, it is essential to contact CanAssistance before incurring any costs. Their team of travel-assistance experts can:
-
direct you to appropriate local medical resources (for example, finding a doctor who can come to your hotel if you’re unable to travel);
-
explain the steps to follow for a claim; and
-
most importantly, confirm what is eligible under your contract.
Good to know: You can also contact CanAssistance before you leave to check the stability of your medical condition and get advice tailored to your destination.
In Summary
-
Missed activities due to illness are not reimbursable.
-
Only additional transportation costs necessary to continue your trip or rejoin the group may be covered.
Always contact CanAssistance as soon as a health issue arises during a trip.