Get Formulaire 1896 - Application For Reimbursement. Application For Reimbursement - Ramq Gouv Qc

The Formulaire 1896 is essential for individuals seeking reimbursement for healthcare services received outside of Québec. This guide provides clear, step-by-step instructions to help users complete the application efficiently and accurately.

Follow the steps to successfully complete the Formulaire 1896.

1. Press the ‘Get Form’ button to obtain the form, ensuring it is accessible through the designated online platform.
2. Carefully review the criteria listed on the form regarding the healthcare services received in Canada or outside Canada. Choose the appropriate box to indicate where the services were obtained.
3. Fill in the applicant's identity section. Enter the last name at birth, last name, health insurance number, date of birth, first name, and sex, using the format specified for date and identification.
4. Complete the home address section, providing the number, street, province, postal code, and any additional relevant details.
5. Specify the periods of time spent outside Québec. Detail the date of departure, return date, and reason for being outside of Québec, ensuring to check only one box for each period.
6. Describe the healthcare services received. Provide a detailed explanation regarding the types of services, treatments, or examinations, as well as the reason for these services.
7. Indicate the amount claimed for reimbursement in Canadian dollars or other currencies, specifying the number of days hospitalized if applicable.
8. Confirm whether you have paid the bills by indicating yes or no, and provide the amount paid along with the original receipts as supporting documents.
9. Complete the travel insurance section, if applicable, by providing the insurance company name and policy number.
10. Sign and date the form, authorizing the Régie de l’assurance maladie du Québec to process the reimbursement request.
11. Save changes to the form. Users can choose to download, print, or share a copy of the completed Application for Reimbursement.

Complete your Application for Reimbursement online today to ensure your healthcare expenses are properly addressed.