Health Care Insurance Plan

In accordance with the Canada Health Act, Alberta has a publicly administered and funded health care system that guarantees Albertans receive universal access to medically necessary hospital and health care services. This means that Albertans are no longer required to pay for Alberta Health Care coverage. However, all Albertans are responsible to pay premiums which they owed before December 31, 2008 unless they qualify for full premium assistance, government sponsored income support programs, or are a senior citizen. All new and returning Alberta residents must still register for Alberta Health Care Insurance Plan (AHCIP) coverage to receive insured hospital and physician services.

For the purposes of the plan, a resident is defined as a person who is lawfully entitled to be or remain in Canada and who makes his or her home in Alberta or is committed to being physically present in Alberta for at least 183 days in a twelve-month period. Tourists, transients, or visitors to Alberta are not considered to be residents, however full-time students and people in the province on work contracts may be.

You must register yourself and your dependents in the plan. Members of the Canadian Armed Forces or the Royal Canadian Mounted Police and inmates at a federal penitentiary are not eligible for registration because they receive coverage from the Federal Government; however, their dependents must be registered. If you were registered in the Plan by your spouse and he dies, contact your local Alberta Health Care Plan office to have the coverage transferred to your name.

If you are separated or living common-law, or in a same-sex relationship with an interdependent relationship agreement, you may register your spouse or partner for coverage. If you are divorced, each spouse will have to register separately. Children must be registered in the name of the parent who has custody. Contact your local Alberta Health Care Plan office to ensure that you have medical coverage.

Always carry your Alberta Health Care Card with you when you are seeking medical services. If you require medical/hospital services outside Alberta, but in another province or territory within Canada you may be able to show your Alberta Health Care Card (and some other identification) and have the service billed directly to Alberta Health Care. However, you may be required to pay up front for the services. Keep your receipts and Alberta Health Care should be able to reimburse you as long as the services provided are included in your Alberta coverage.

Who Is an Eligible Dependent?

Your spouse, common-law partner, partner with whom you have an adult interdependent relationship and any children who are under twenty-one years, single, and wholly dependent on you for support are eligible dependents. Children who are single and dependent, full-time students, and under the age of twenty-five are considered eligible dependents as well as children who are single, over twenty-one and wholly dependent due to a physical/mental disability. The definition of children includes not only natural children, but adopted children, and wards for whom you are entitled to claim deductions for income tax purposes.

Are There Any Waiting Periods for Coverage?

If you have moved to Alberta from another province, you are eligible for coverage on the first day of the third month after your arrival. In the meantime, you can send any medical receipts to the provincial health care agency from the province you came from. If you have arrived in Alberta from a place outside of Canada, there is no waiting period provided that you apply for coverage within three months of the date on which you arrived in Alberta. Otherwise, you will not be eligible until the first day of the third month after your arrival. If you had already been registered in the Plan by a spouse or common-law partner but you are now separated, divorced, or widowed or if you have since turned twenty-one or become fully independent, there will be no waiting period.

Can I Get Extra Coverage?

Extra coverage for services that are not covered by Alberta Health Care is available through Alberta Blue Cross and other extended health care programs. There is generally a cost involved for coverage under these plans unless you qualify for an exemption from payment, for example, senior citizens and their dependents, and widows or widowers receiving the Alberta Widows’ Pension and their dependents will not have to pay for extra coverage for basic extras, however, if they wish more than the basic extras then they will have to pay for these. The amount paid by the Plan for any medical treatment that you require when you are outside of Alberta is based on fees paid in Alberta. If you become sick or hurt when you are out of Alberta, the medical bills could be much greater than the amount which your Alberta Plan will pay. Unless you have some  additional coverage, you may be personally liable for any costs not covered by the Plan. The extra expense could cause you serious financial hardship. Sometimes, a hospital will place restrictions upon you until the bill is paid. For example, a woman who has given birth to a child while on vacation outside of the country may not be allowed to remove her baby from the hospital until all hospital costs and doctors’ fees are paid. In such situations it would be wise to have additional coverage.

Contact your local Health Care Insurance Plan for further information and application forms. Your travel agent may also have information on additional coverage for those who are travelling outside of Canada.