Health Care-Alberta

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Alberta Health Care Insurance Plan

Eligibility

International relocation

If you arrive from outside of Canada and take up residence in Alberta, you and your dependants are eligible for enrollment with the Alberta Health Care Insurance Plan from Day 1.

In order to qualify, you have to be:

  • legally entitled to reside in Canada (e.g., Canadian citizen, permanent resident, work permit holder, study permit holder)
  • a resident of Alberta
  • physically present in Alberta for 183 days of each year (some exceptions are permitted, e.g., when people's work requires extensive out-of-province travel)
  • a bona fide resident and not a visitor

Note: Two separate phone conversations with AHCIP personnel in March 2008 confirmed that the rules for work permit holders had changed. You now have to have a work permit that is valid for a minimum of 10 months in order to be eligible for AHCIP.

Dependant

A dependant is defined as:

  • spouse
  • separated spouse
  • common law spouse
  • same sex partner
  • single child who is under the age of 21 and entirely dependent on the parent(s)
  • single child who is 21 years of age or older and entirely dependent on the parent(s) because of physical or mental disabilities
  • single child who is under 25 years of age and enrolled in three or more courses at an accredited educational institute

Note 1: A divorced spouse is not considered to be a dependent and should register separately.

Note 2: If you are a permanent resident of Canada and your spouse/partner is in Alberta with some form of visitor status of more than 6 months, they can be added as a spouse on your Alberta health coverage.

Inter-provincial relocation

If you arrive in Alberta from another Canadian province, you are eligible to join the provincial health care plan on the first day of the third month following your arrival. So if you arrive on July 15th, you can join on October 1st. It would be typical for your previous province to give you three months' worth of coverage following your departure from that province. You should remain registered with the health care insurance plan of your previous province until you register with AHCIP.

Landing at different times

Conflicting information has been received on the British Expats forum about what happens when one member of a family lands in Alberta and other members of the family follow some months later. AHCIP appears to have told different people different things. Sometimes the advice has been to maintain medical insurance coverage for the whole family at the old location until everyone moves to Alberta. At other times the family member who has arrived first has been advised to register with AHCIP as a single person and to switch to family coverage when his/her family members join him/her in Alberta. If you will be in that situation, it may pay you to e-mail AHCIP and ask for clarification.

Registration

Registration with Alberta Health Care Insurance Plan is compulsory. You may "opt out" of AHCIP, but you still have to register.

Here are instructions for registration.

Please note that you do not need a Social Insurance Number in order to register with Alberta Health Care Insurance Plan.

After you have completed the application form, you and your partner have signed it, and you have attached photocopies of the required documents, you can mail it to:

Alberta Health and Wellness
PO Box 1360, Station Main
Edmonton, Alberta
T5J 2N3

Alternatively, you may submit the application in person at the Edmonton or Calgary office of Alberta Health and Wellness:

  • 10025 Jasper Avenue, Edmonton
  • 727 - 7th Avenue SW, Calgary

Office hours are 8.15 a.m. to 4.30 p.m., Monday to Friday.

Premiums

As of January 1st, 2009, AHCIP premiums were eliminated. Albertans now receive AHCIP coverage for free.

There were two premium rates:

  • $44 per month for a single person
  • $88 per month for a family of two or more people

Senior citizens (people aged 65 or older) were exempt from AHCIP premiums.

Coverage

AHCIP covers the costs of the following services and products:

  • doctor visits
  • tests that a doctor orders (X-Rays, blood tests, etc.)
  • hospital stay in a public ward (which typically accommodates four beds)
  • surgery
  • drugs administered in a hospital setting
  • standard children's immunizations
  • palliative care drugs for people receiving treatment at home
  • drugs for the treatment of cancer, regardless of where they are administered
  • limited amount of community-based rehabilitation services, such as physiotherapy
  • eye exams for children and youth aged 18 and under as well as for seniors (65+)
  • prescription drugs for seniors (65+)

Exclusions

Services and products that are excluded from AHCIP's coverage:

  • prescription drugs administered outside of a hospital setting, e.g., a doctor's prescription that is filled at a pharmacy (diabetics should note that the cost of insulin is not covered by AHCIP)
  • dental care
  • routine eye exams for adults aged 19 to 64 years
  • eyeglasses
  • ambulance
  • private hospital room
  • psychological counselling
  • acupuncture
  • massage therapy
  • midwifery
  • homeopathy
  • physiotherapy over and above AHCIP's allotment
  • cosmetic surgery
  • sex change surgery

Dentists, psychologists, acupuncturists, massage therapists, midwives and homeopaths are allowed to provide services in Alberta, but they do so as private practitioners, outside of the AHCIP system. AHCIP covers some, but not all, of the services delivered by optometrists and physiotherapists.

Travel

AHCIP covers your medical treatment while you're travelling in other Canadian provinces. In many cases, health care providers in other provinces will invoice AHCIP directly.

AHCIP provides limited medical insurance coverage outside of Canada. It reimburses you up to C$100 per day for inpatient hospital services and up to C$50 per day for outpatient hospital services in another country. The cost of emergency medical treatment in foreign hospitals can far exceed AHCIP's reimbursement, so it is wise to buy travel medical insurance.

There have been some instances in which AHCIP has sent patients to other jurisdictions, at AHCIP's expense, because certain kinds of hospital facilities in Alberta have been stretched to the limit. There have been recent examples of patients being sent to Montana and Ontario at AHCIP's expense.

Private medical and dental insurance

There are a number of companies that sell supplementary health care insurance, that is, insurance that covers the aspects of medical and dental treatment that Alberta Health Care Insurance Plan does not cover. These companies include:

  • Manulife
  • Sunlife
  • Greenlife
  • Great West Life

It is common for employees and their dependants to be covered by group medical and dental insurance plans that their employers offer. It is common for these plans to have an annual deductible (excess), an annual cap on major expenses like orthodontic treatment, and possibly a requirement for a small co-payment for each expense incurred.

Alberta Health Care Insurance Plan also sells supplementary medical insurance in the form of Blue Cross Non-Group Prescription Drug Coverage. This plan is aimed at AHCIP subscribers who are under 65 years of age. (Seniors don't need to pay for Blue Cross coverage; they get it for free.) Each time you get a prescription filled, you pay 30 per cent of the cost, to a maximum of $25, for each drug. Alberta Blue Cross premiums cost $61.50 per quarter for a single person and $123 per quarter for a family of two or more people. Premiums are billed quarterly, but they work out to $20.50 per month of a single person and $41 per month for a family.

If you own a small business, you can get your company to pay dental, medical, prescription drug and vision care insurance premiums on behalf of you and your family members. This is deemed to be an expense of running the company, and the expense can be deducted from your company's taxable income. Quikcard is one of the companies that offers this kind of insurance.

Finding a doctor

It is quite a challenge to find a Calgary doctor who is accepting new patients.

The College of Physicians and Surgeons of Alberta maintains a list of doctors who are accepting new patients.

If you need medical treatment while you're still looking for a doctor, an interim solution is to go to a walk-in medical clinic.