Foster Child Medical Coverage and Foster Parent Leave in Quebec

Two practical questions come up quickly for anyone seriously considering foster care: what happens when the child needs medical care, and what do I do about work? These are not peripheral concerns — they affect whether fostering is logistically possible for a working family. In Quebec, the answers are different from what you might find in Ontario or BC guides, and some of the gaps in employment leave protections are significant.

Medical Coverage: RAMQ for Foster Children

Children in foster care in Quebec are covered by the Régie de l'assurance maladie du Québec (RAMQ) — the provincial public health insurance plan. This applies from the moment a child enters placement and covers:

• General practitioner visits
• Specialist referrals
• Emergency room care
• Hospitalization
• Prescription medications covered under the public drug plan
• Dental care (for children under 10, covered under the public program; for older children in care, arrangements are made through the DPJ)

The RAMQ coverage means that routine and urgent medical care for a foster child does not come out of your pocket. You will not be submitting medical bills for reimbursement in most cases — the child's provincial coverage handles it directly.

When a child arrives in your home, you should receive their RAMQ card or a temporary health insurance number within 72 hours of placement. Your DPJ caseworker is responsible for ensuring this happens. If it does not, follow up immediately — you should not delay necessary medical care waiting for documentation, but having the RAMQ number available makes appointments significantly easier.

What the Daily Compensation Covers (And Doesn't)

The daily compensation rates — $26.47 to $41.22 per day depending on age, plus supplements for specialized placements — are intended to cover the child's living expenses: food, clothing, household expenses, activities, and personal care items.

Separate allowances exist for:

• Annual clothing: $327.30 to $516.83 per year depending on age
• School supplies: Approximately $126.31 per year for elementary school children
• Personal expenses: $5.00 per day
• Respite: Up to $783.04 annually for the foster family

These amounts are non-taxable. They are classified as expense reimbursements, not income, which means they do not count toward your taxable income for federal or provincial purposes.

The Canada Child Benefit: Why Foster Parents Don't Receive It

A common misconception is that foster parents can claim the Canada Child Benefit (CCB) for foster children. They cannot.

The CCB is structured for individuals who are responsible for a child's care and have the child living with them — but the specific CRA eligibility rules exclude children who are placed in foster care by a government agency. For these children, the equivalent amount is paid by the federal government as a "Children's Special Allowance" (CSA), at the same rate as the CCB, but directly to the maintaining agency (the regional CIUSSS).

The practical effect: the government pays the equivalent amount — it just goes to the institution, not to you. This is one reason why the collective agreement compensation structure matters. The daily rates are calibrated to cover actual expenses without the benefit of CCB.

If you have your own biological or adopted children living in your home, your CCB for those children is not affected by the presence of a foster child. However, you may need to notify Retraite Québec to ensure your provincial family allowance calculation correctly reflects your household. Adding a foster child does not necessarily increase the family allowance for your own children, but changes to household composition should be reported.

Foster Parent Employment Leave in Quebec

This is where the picture becomes more complicated. Employment leave for foster parents in Quebec is not as robust as what exists for adoptive parents, and it varies significantly based on your employment situation.

Provincial Employment Standards

Quebec's Act Respecting Labour Standards provides for parental leave for employees — but the default provisions are designed for biological or adoptive parents, not foster parents. A standard regular foster placement does not automatically trigger the parental leave entitlements available to adoptive parents.

If you are fostering through the banque mixte program — specifically fostering with the explicit intent to adopt — you may be entitled to parental benefits through the Quebec Parental Insurance Plan (QPIP) once the formal adoption process begins. But this applies only after the court has issued a placement order for adoption, not during the foster placement phase that precedes it.

Federal Employment Insurance (EI)

Under the federal Employment Insurance program, parental benefits are available for biological and adoptive parents. As of recent years, an employee who becomes a foster parent with the explicit intent to adopt (and where provincial approval is imminent) may qualify for EI parental benefits. However, regular foster placement — without an anticipated adoption — does not qualify.

If you anticipate an adoption through the banque mixte program, speak with your employer's HR department and your Service Canada office about the timing and documentation required.

Public Sector Employees

For public servants, the situation is governed by collective agreements between employers (federal or provincial) and employee unions. A well-known situation for federal public servants is that family-related responsibility leave under agreements like the PA (Program Administration) agreement provides only a limited number of days — often as few as one week — for the arrival of a foster child, compared to the weeks or months available for adoptive parents.

This creates a real operational challenge: if a foster placement starts on short notice (as emergency placements often do), a public servant may have very limited paid leave to cover the initial transition period. Unless the placement is intended to lead to adoption, they may need to rely on vacation leave, personal days, or flexible work arrangements negotiated with their manager.

If you are a federal or provincial public servant and seriously considering foster care, reviewing your specific collective agreement's family leave provisions before you begin the application process is an important step.

Self-Employed and Non-Standard Workers

Self-employed individuals in Quebec who have opted into EI self-employment coverage may access parental benefits under the same rules as employed workers in adoption situations. For regular foster placements, the situation is the same — EI parental benefits do not automatically apply.

Planning for the Financial Reality

The practical financial picture for a foster parent in Quebec looks like this:

• Daily compensation covers the child's living expenses but does not constitute meaningful additional income for the household
• RAMQ covers medical care for the child at no direct cost to you
• Canada Child Benefit is not available for foster children
• Employment leave is limited for regular foster placements, requiring prior planning with your employer
• For banque mixte (anticipated adoption) placements, parental benefits may be available once the adoption process is formally initiated

The families for whom fostering is most financially manageable tend to have one of several conditions: at least one partner who works flexible hours or from home, an established workplace accommodation with a supportive employer, a household income stable enough that limited leave is workable, or a placement profile (specialized or banque mixte) that qualifies for enhanced compensation or formal parental leave.

For a complete overview of the Quebec foster care financial and employment framework — including the collective agreement terms, how compensation is reviewed when a child's needs change, and what recourse you have if compensation is not paid correctly — the Quebec Foster Care Guide covers the system in full English.

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