RAMQ eligibility criteria

June 30, 2014 by Charles Halluin

RAMQ

The Régie de l’assurance maladie du Québec (RAMQ) eligibility criteria are mainly based on age and the degree of hearing loss. Those eligible under the hearing aid program can benefit from one or two hearing aids from the RAMQ list in effect since 2010.

Below is a summary of the main eligibility criteria

  • Children 0 to 12 years of age: One or two hearing aids are covered by the RAMQ hearing aid program if the hearing impairment is likely to compromise language or learning.
  • Children 12 to 18 years of age and students aged 19 and up: One or two hearing aids are covered by the RAMQ hearing aid program if the affected ear has a pure tone average (PTA) loss of 25 dB or greater for the frequencies of 500, 1,000, 2,000 and 4,000 Hz.
  • Adult workers aged 19 and up: One or two hearing aids are covered by the RAMQ hearing aid program if the better ear has a PTA loss of 35 dB or greater for the frequencies of 500, 1,000 and 2,000 Hz.
  • Adults aged 19 and up who do not work: One hearing aid is covered by the RAMQ hearing aid program if the better ear has a PTA loss of 35 dB or greater for the frequencies of 500, 1,000 and 2,000 Hz.
  • People with deaf-blindness: One or two hearing aids are covered by the RAMQ hearing aid program.

The RAMQ eligibility criteria are not the only factors that define the need for hearing aids. A recommendation for hearing aids must also take into account the communication difficulties that arise in certain environments and communication needs.

Child under 12

RAMQ

HEARING LOSS 

  • In accordance with the hearing aid need in the affected ear

REQUIRED DOCUMENTS

  • Medical certificate issued by an ENT specialist
  • Attestation of the need for a hearing aid issued by an audiologist
  • Overall assessment of needs issued by an audiologist

Child 12 to 18

Résumé des critères d'admissibilité de la RAMQ

HEARING LOSS 

  • PTA of 25 dB across 4 frequencies in the affected ear

REQUIRED DOCUMENTS

  • Medical certificate issued by an ENT specialist
  • Audiogram issued by an ENT specialist or audiologist
  • Attestation of the need for a hearing aid issued by an ENT specialist or audiologist
  • Overall assessment of needs issued by an audiologist

Student 19 and up

Résumé des critères d'admissibilité de la RAMQ

HEARING LOSS 

  • PTA of 25 dB across 4 frequencies in the affected ear

REQUIRED DOCUMENTS

  • Medical certificate issued by an ENT specialist
  • Audiogram issued by an ENT specialist or audiologist
  • Attestation of the need for a hearing aid issued by an ENT specialist or audiologist
  • Proof of school attendance (recognized by the Ministère de l’Éducation, du Loisir et du Sport)
  • Overall assessment of needs issued by an audiologist for binaural hearing aids

Retirement age is not an eligibility criterion for the RAMQ hearing aid program.

Adult worker 19 and up

Résumé des critères d'admissibilité de la RAMQ

HEARING LOSS 

  • PTA of 35 dB across 3 frequencies in both ears

REQUIRED DOCUMENTS

  • Medical certificate issued by an ENT specialist
  • Audiogram issued by an ENT specialist or audiologist
  • Attestation of the need for a hearing aid issued by an ENT specialist or audiologist
  • Work certificate
  • Attestation of the need for hearing aids and overall assessment of needs issued by an audiologist for binaural hearing aids

Adult who does not work 19 to 64

Résumé des critères d'admissibilité de la RAMQ

HEARING LOSS 

  • PTA of 35 dB across 3 frequencies in both ears

REQUIRED DOCUMENTS

  • Medical certificate issued by an ENT specialist
  • Audiogram issued by an ENT specialist or audiologist
  • Attestation of the need for a hearing aid issued by an ENT specialist or audiologist

Adult who does not work 65 and up

RAMQ

HEARING LOSS 

  • PTA of 35 dB across 3 frequencies in both ears

REQUIRED DOCUMENTS

  • Medical certificate issued by an ENT specialist
  • Audiogram issued by an audiologist
  • Attestation of the need for a hearing aid issued by an audiologist
  • Overall assessment of needs issued by an audiologist

Person with deaf-blindness

RAMQ

HEARING LOSS 

  • In accordance with the hearing aid need in the affected ears

REQUIRED DOCUMENTS

  • Medical certificate issued by an ENT specialist
  • Audiogram issued by an ENT specialist or audiologist
  • Attestation of the need for a hearing aid issued by an audiologist
  • Overall assessment of needs issued by an audiologist
  • Attestation of visual impairment issued by a recognized entity (e.g. Centre d’hébergement Louis-Hébert in Québec City and Institut Nazareth et Louis-Braille in Montréal)

Note: This table is only a summary of the RAMQ eligibility criteria. Additional criteria may apply.

Visit www.ramq.gouv.qc.ca.

To obtain more information on the RAMQ hearing aid program, consult an audioprosthetist at one of the Lobe Santé auditive et communication multidisciplinary clinics.

Reference:

  • Régie de l’assurance maladie du QuébeC [online]. Page consulted on February 18, 2014. http://www.ramq.gouv.qc.ca/en/citizens/aid-programs/devices-compensate-physical-deficiency/Pages/devices-compensate-physical-deficiency.aspx