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Ambulance cost in Quebec: the rate, who pays, who is exempt

An ambulance transport costs $125 plus $1.75 per kilometre in Quebec. Who gets the bill, who does not pay, and what the RAMQ does not cover.

October 10, 2026 · Lire en français

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The cost of an ambulance transport in Quebec is $125, plus $1.75 per kilometre travelled. These amounts appear on Québec.ca and in the ministerial order that sets the rates, up to date as of June 1, 2026 on LégisQuébec. The bill goes to the person transported, never to the paramedic (primary care paramedic) who did the transport. In an emergency, dial 911.

The current rate

The Québec.ca page Coût du transport en ambulance, updated on August 20, 2024, gives three amounts. Section 5 of the ministerial order (chapter L-0.2, r. 2) gives the same ones.

Item billed	Amount
Pick-up	$125
Travel to the hospital centre	$1.75 per kilometre travelled
Additional patient in the same ambulance	$35 per person
Pick-up of a person who does not reside in Canada	$400, plus $1.75 per kilometre

A 10-kilometre transport therefore costs a resident $142.50, that is $125 plus $17.50 for travel. This is a calculation based on the rate, not an amount taken from a source.

Urgences-santé (the ambulance service for Montreal and Laval) presents the rate for non-residents of Canada differently: $125 base and a $275 surcharge, plus $1.75 per kilometre. The total matches the $400 on Québec.ca. Urgences-santé specifies that the $35 does not apply to medical, family or social companions.

The order says these rates apply to all of Quebec and to all holders of an ambulance service permit. The last decree that amended section 5 is decree 185-97. Urgences-santé writes that the rates have not increased since 1997.

Who pays the bill

Québec.ca is clear: the trip must be paid by the person transported, even if someone else called 911. Urgences-santé adds that the relative, police officer or witness who requested the ambulance is not responsible for payment.

Nothing is paid on the spot. According to Urgences-santé, the document handed over at the time of transport is an attestation, and the official bill is sent later.

Who does not pay

Québec.ca lists the situations where the cost is covered by another payer.

Person injured in a road accident: the Société de l'assurance automobile du Québec (SAAQ, Quebec's driver licensing and auto insurance board) pays
Person aged 65 or over: the hospital centre pays, subject to approval by the physician in charge
Recipient of the Social Assistance Program or the Social Solidarity Program: the Ministère du Travail, de l'Emploi et de la Solidarité sociale pays, subject to approval by the physician in charge
Person transported between two institutions of the health and social services network: the two institutions pay
Workplace accident: the employer pays

So being 65 is not enough. Québec.ca warns that a person eligible for an exception measure could have to pay if the transport is not deemed medically necessary. Urgences-santé, for its part, writes that transport for people 65 and over is free if it is medically or socially required.

For road accidents, Urgences-santé sets a condition: the transport must be related to the accident. For workplace accidents, the CNESST (Quebec's labour standards and workplace safety board) writes that the employer must cover ambulance transport costs, and its page also provides for cases where it reimburses these costs itself.

For transfers between institutions, section 4 of the order requires that stretcher transport be required by the attending physician or a specialized nurse practitioner and authorized by the institution of departure. Urgences-santé notes an exception in Montreal: CLSCs are excluded from this free coverage.

The federal government pays for four groups, again according to Québec.ca: members of the Canadian Armed Forces, veterans, Indigenous people registered on a reserve and people detained in a correctional centre.

In all these cases, the transport is not free: someone else gets the bill. Section 5 of the order specifies that its rates apply to all paying agents. The Auditor General of Quebec gives the scale for the 43 ambulance companies: in 2023-2024, billing brought them $85.2 million, of which $18.7 million came from citizens and $66.5 million was paid mainly by the government, because users benefit from free coverage.

A medical prescription does not make the transport free. Urgences-santé writes that it justifies the relevance of the transport, not its free coverage.

A rate unchanged since 1997

A reader pointed it out to us: the price has not moved in years. The Auditor General of Quebec confirms it in its May 2025 report. The last update of the rates dates back to 1997, and the main free coverage criteria date from the early 1990s.

Meanwhile, the cost of the service has risen. The average cost of a transport is $1,214 in 2023-2024, and the average amount billed to the user is $154. The share paid by billing fell from 36% to 13%. The Government of Quebec makes up the difference, $1,060 per transport on average. The report names the Ministère de la Santé et des Services sociaux (MSSS), Quebec's health ministry, and other sources. It is not the RAMQ (Quebec's health insurance board), which does not cover ambulance transport.

The Ministère de la Santé et des Services sociaux began analyses in fall 2024. The report cites one example: a $150 pick-up fee instead of $125, with free coverage at 70 instead of 65, would reduce government spending by about $18 million per year. No decision had been made at the end of the Auditor General's work.

If the person is not transported

The same reader asks whether there are fees when the person refuses transport. The rate targets transport. Section 5 of the order sets only three rates: the pick-up of a patient, the pick-up of an additional patient and the kilometre travelled by ambulance with the patient. It sets no rate for a trip without transport.

Québec.ca points the same way: the trip to a hospital centre must be paid by the person transported. The Auditor General notes, for its part, that in some cases such as a refusal of transport, the patient is not transported. No official source consulted on October 13, 2026 announces a fee for a trip without transport.

Paying the bill in Montreal and Laval

Urgences-santé gives 28 days from the date written on the bill. After that, interest charges are added. Payment can be made online, by mail, at a financial institution or in person at 6700 Jarry Street East, in Montreal.

In case of financial difficulty, Urgences-santé asks you to contact its Customer Accounts Department at 514 723-5600, extension 5666, or at compte-client@urgences-sante.qc.ca. Elsewhere in Quebec, the terms are those of the organization named on your bill.

Group or individual insurance can cover these costs, often in part. Urgences-santé does not claim anything from the insurer: you pay the bill, then submit it yourself.

The tax credit for medical expenses

Revenu Québec names ambulance transport. Its page on line 381 includes among medical expenses the cost of transporting a person by ambulance to or from a public hospital centre or an accredited private hospital centre. Only the part of medical expenses that exceeds 3% of income (line 275) goes on this line, for the 2025 taxation year. This text is not tax advice or legal advice.

Also read: a paramedic's salary in Quebec and the job of 911 dispatcher.

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Frequently asked questions

Does the RAMQ reimburse ambulance fees?

No. The Régie de l'assurance maladie du Québec says so in its FAQ: "We do not cover the costs of ambulance transport." The health insurance card is therefore not used to pay the bill. The RAMQ refers to the exception measures described on Québec.ca.

What is the price of an ambulance trip?

The trip itself costs $1.75 per kilometre travelled to the hospital centre, according to Québec.ca. This amount is added to the $125 pick-up fee. The ministerial order specifies that the mileage counted is the distance travelled by ambulance with the patient.

What will the ambulance rate be in 2026?

In 2026, the rate remains $125 plus $1.75 per kilometre, according to the ministerial order up to date as of June 1, 2026 on LégisQuébec. Québec.ca indicates that these rates may be subject to annual indexation. No official source consulted on October 10, 2026 announces a new amount.

What is the price of an ambulance?

For a person who resides in Canada, the price is $125 for the pick-up and $1.75 per kilometre travelled. For a person who does not reside in Canada, the pick-up rises to $400. Several groups pay nothing, including road accident victims and, under conditions, people 65 and over.

Do you pay for an ambulance in Quebec?

Yes. Québec.ca writes that the trip must be paid by the person transported, even if someone else called 911. Nothing is paid on the spot. According to Urgences-santé, the official bill is sent after the transport.

Is the ambulance free for seniors?

Not automatically. For a person aged 65 or over, Québec.ca indicates that the hospital centre pays, subject to approval by the physician in charge. The same page warns that an eligible person could have to pay if the transport is not deemed medically necessary.

Who can get a free ambulance?

Québec.ca names the people whose transport is paid by someone else: people injured in a road accident (SAAQ), recipients of social assistance or social solidarity, people transferred between two network institutions and victims of a workplace accident (employer). The federal government pays for members of the Canadian Armed Forces, veterans, Indigenous people registered on a reserve and people detained in a correctional centre. Each measure has its conditions, described above.

How do you get an ambulance bill reimbursed?

Three routes exist depending on your situation. Group or individual insurance can cover these costs: you pay the bill, then submit it yourself to the insurer, according to Urgences-santé. After a workplace accident, the CNESST page provides for cases where it reimburses ambulance transport costs. Revenu Québec also includes these costs among the medical expenses on line 381 of the income tax return.

How do you pay an ambulance bill online?

For a transport in Montreal or Laval, the Urgences-santé page Payer une facture offers online payment through PayPal, "with or without a PayPal account". You enter the bill amount and its number, which is mandatory. Elsewhere in Quebec, the payment methods are those of the organization named on your bill.