Alberta provincial health plan fact sheet

Your Alberta Health Care Insurance Plan provides:

Prescription drugs

  • Premium-free coverage for seniors age 65 and over; residents under age 65 who enrol pay quarterly premiums. 
    •  Eligible residents pay a percentage the cost of prescription drugs, up to a dollar maximum per prescription or refill.
      • The dollar maximum is not applicable when a product is chosen over the lowest cost alternative, the patient pays the difference.
      • Only prescription drugs listed in the Alberta Drug Benefit list are covered.
    • Coverage of diabetic supplies for insulin-treated diabetics only, up to a dollar maximum per eligible person each benefit year, for diabetic supplies including needles, syringes, lancets, and both blood glucose and urine testing strips.

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  • The Alberta government sets a maximum cost of reimbursement for dispensing fees and ingredient cost.

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Ambulance

  • No coverage for ground ambulance services, with the following exceptions:
    • Coverage for seniors and widows through Alberta Blue Cross
    • Coverage for those receiving income support and for eligible individuals and families with limited incomes
    • Hospital-to-hospital transfers as provided through regional health authorities 

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Dental benefits

  • No coverage for routine dental care such as cleaning, fillings and the extraction of wisdom teeth
  • Partial coverage for some specific dental, oral and maxillofacial surgical services

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Vision care

  • No coverage for routine eye exams for residents ages 19 to 64, refractive laser eye surgery, eyeglasses and contact lenses
  • Coverage for one complete eye exam, one partial exam and one diagnostic procedure per benefit year for residents age 18 and under, or age 65 and older
  • Coverage for some specific medical conditions treated by optometrists

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Nursing benefits and home care

  • Some coverage for residents of continuing care centres (nursing homes and auxiliary hospitals) for those who qualify
  • Some coverage for home care services to assist independent living is provided based on the assessed needs of the patient  

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Hearing aids and medical supplies

  • Limited coverage under the Alberta Aids to Daily Living Program for disabled, chronically ill or terminally ill claimants

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Accidental death and dismemberment

  • No coverage.

Hospital

  • Coverage for accommodations at a standard level and meals

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Paramedical

  • No coverage for services provided by a chiropractor, acupuncturist, massage therapist, homeopath, nutritionist, psychologist, physician assistant or nurse practitioner.
  • Coverage for some physiotherapy services through the Community Rehabilitation Program administered by the regional health authorities. Persons are assessed according to need and assigned a priority rating using a scale of three to 15. Those assigned a priority of seven or higher are eligible for services through the program.
  • Coverage for some podiatric services and appliances are payable at specific rates per service, per person, per benefit year.
  • Private insurers aren’t allowed to pay benefits for services provided by some paramedical practitioners until the government’s yearly benefit maximum has been reached

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  • Chiropractic services for Alberta seniors will be eligible if enrolled in the Coverage for Seniors health benefit.
  • Psychological services for Alberta seniors will be eligible if enrolled in the Coverage for Seniors health benefit.

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Out of country

  • No coverage for air or ground ambulance outside of Alberta
  • Coverage for the services of physicians out of Canada, up to Alberta rates only
  • Coverage is available for hospital services; however, they must be services that would normally be covered by the AHCIP and must be provided in a general or auxiliary hospital.
  • Payment for hospital services provided in a private health facility will not be reimbursed.
  • Hospital-services rates apply

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These highlights from the Alberta Health Care Insurance Plan are for general reference only and are subject to change, corrections and updates. Other government programs may also be available. For more information on the latest coverage details, please contact Alberta Health and Wellness at:

Alberta Health

Attention: Alberta Health Care Insurance Plan

P.O. Box 1360 Station Main

Edmonton, AB  T5J 2N3 


In Edmonton, phone: 780-427-1432

Toll-free for the rest of Alberta, dial 310-0000 then 780-427-1432

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Updated: January 2020