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PROVINCIAL/ TERRITORIAL HEALTH PROGRAMS
Alberta Health Care Insurance Plan (AHCIP)
under Alberta Health Care Insurance Plan
Alberta Health and Wellness contracts with Alberta Blue Cross to offer three supplementary health plans:
- Non-Group Drug Coverage
- Drug Coverage for Seniors
- Palliative Care Drug Coverage
HEALTH PREMIUMS/TAXES
Single $44.00/month
Family $88.00/month
*Individuals are responsible for costs though some employers may pay
** Income-based premium subsidies are available
*** Seniors are exempt
Not applicable
WHEN COVERAGE BEGINS
Coverage on the first day of the third month following the date permanent residency is established in Alberta;
If family members arrive at a later date, coverage on the first day of the third month following the date family arrives in Alberta.
Coverage on the date of arrival in Alberta
HOW LONG COVERAGE CONTINUES
Balance of the month in which you leave the province plus two consecutive months
First three months after departure
Coverage is maintained during an absence of up to 183 days in any 12 month period if Alberta remains the permanent and principal home
OUT OF PROVINCE / COUNTRY COVERAGE
Medically required physician, osteopath and hospital services;
Claims paid at the standard rates of the province/territory where services were obtained;
Required to pay directly for dental, chiropractic, podiatry and optometry services received outside Alberta and submit a claim for these services;
Limited benefits paid at the same rate as payable in Alberta;
Maximum benefits apply.
Hospital services must be provided in an active-treatment general or auxiliary hospital;
Maximum amount for hospital in-patient care provided outside Canada - $100 per day, not including the day of discharge;
In-patient and out-patient hospital rates are all-inclusive;
Out-of-country practitioner services payable at the rate an Alberta practitioner would receive on a fee-for-service basis or the amount billed, whichever is less;
Maximum amount for routine hospital outpatient services - $50 per visit with a limit of one visit per day.
WHAT IS COVERED
Medically required services associated with physician and diagnostic services and hospital in-and-out patient care.
Coverage for children under 19 years of age or age 65 and over for:
- One complete exam
- One partial exam and one diagnostic procedure per benefit year
Additional benefits for these age groups for some medical conditions.
Certain medically necessary surgical-dental procedures which are performed in hospital by a dentist or oral surgeon.
Standard ward hospitalization in an approved hospital and in-patient services such as:
- Accommodation and meals at the standard or public ward level
- Necessary nursing services
- Laboratory, radiological and other diagnostic procedures, together with the necessary interpretation, for the purpose of maintaining health, preventing disease and assisting in the diagnosis and treatment of any injury, illness or disability
- Drugs, biologicals and related preparations when administered in a hospital, as specified in the Agreement
- Use of operating room, case room and anaesthetic facilities, including necessary equipment and supplies, where available
- Routine surgical supplies
- Use of radiotherapy facilities, where available
- Use of physical therapy facilities, where available
- Services rendered by persons who receive remuneration for those services from the hospital
PARAMEDICAL SERVICES
Not covered
- Services may be covered by regional health authority (RHA) Community Rehabilitation Program
$13.23 per visit
$21.90 for one annual x-ray
maximum of $200 per person each benefit year
Not covered unless osteopath is registered as an osteopathic practitioner under the Medical Profession Act.
Podiatry (foot care) – set benefits are payable for specific services;
Maximum benefit $250 per person each benefit year.
Albertans are responsible for the cost of prescription drugs to them outside hospitals, auxillary hospitals and nursing homes. Alberta Health and Wellness contracts with Alberta Blue Cross to offer three supplementary drug plans:
General:
- Non-Group Coverage
- A universal prescription drug plan available to all Alberta residents under the age of 65 years and their dependants
- Must be an Alberta resident, under the age of 65 years, registered with the AHCIP and have not opted out of the plan and not in arrears for AHCIP
- Coverage will become effective on the first day of the fourth month after application received
- Program covers 70% of cost of prescription drugs
- Co-payment - 30% of cost, to a maximum of $25, for each drug prescribed
- Alberta Blue Cross premiums on a quarterly basis
- Seniors
- Coverage for Seniors - for Albertans 65 years of age and older and their dependants, and recipients of the Alberta Widows' Pension and their dependants
- Special Needs
- Palliative Care Drug Coverage - for people diagnosed as being palliative and receiving their treatments at home
Premium Subsidy
Income levels for the Full Premium Subsidy Program and Full Premiums:
Full Subsidy
Single: <$17,450
Family/No Children: <$26,200
Family/With Children: <$32,210
Full Premium:
Single: >20,970
Family/No Children: >33,240
Family/With Children: >39,250
Drug Subsidy
Alberta Blue Cross premiums (payable quarterly)
Regular Premium: Single/$61.40 and Family/$123
Subsidized Premium: Single/$43.05 and Family/$86.10
* those who qualify for AB Health Care Insurance subsidy will qualify for subsidized Alberta Blue Cross non-group premiums
Not covered
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