Alberta provincial health care plan (AHCIP)

Eligibility and coverage details for Alberta

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GHIP

Who is covered by the Alberta provincial government health care plan?

The Alberta Health Care Insurance Plan (AHCIP) covers all Alberta residents. It provides essential healthcare services like doctor visits, hospital care, and select surgeries. You must register to receive coverage.

GHIP

Are you eligible?

To qualify for the Alberta Health Care Insurance Plan (AHCIP), you must be a resident of Alberta for at least 6 months each year. Coverage begins once your application is approved. Certain exceptions apply.

What's covered

Coverage details for the Alberta provincial Health Care Plan (AHCIP)

Benefit
Coverage details
Prescription Drugs

The Alberta Health Care Insurance Plan (AHCIP) provides coverage for eligible prescription drugs listed on the Alberta Drug Benefit List for low-income residents, including seniors aged 65 and older. Depending on the drug, you may be required to pay premiums and a percentage of the drug cost, up to a maximum per prescription. For those without group insurance, the Non-Group Coverage program offers coverage for supplementary health benefits, including prescription drugs. Alberta’s Biosimilars Initiative mandates that only biosimilar versions of eligible drugs are covered under AHCIP.

Ambulance

Ground ambulance services are generally not covered under the Alberta Health Care Insurance Plan (AHCIP) unless you meet specific criteria. You may be eligible for coverage if you are a senior citizen (65+), receiving income support, or belong to a low-income household. Ambulance services are covered for hospital-to-hospital transfers. In other cases, residents are typically responsible for the full cost. Learn more about ambulance service billing information.

Dental benefits

Routine dental services, such as cleanings, fillings, and extractions, are not covered under the Alberta Health Care Insurance Plan (AHCIP). However, partial coverage is available for specific dental, oral, or maxillofacial surgeries when they are medically required, such as for severe oral health conditions or trauma.

Vision care

Alberta Health Care Insurance Plan (AHCIP) covers one complete eye exam, one partial eye exam, and one diagnostic procedure per benefit year for residents aged 18 and under, or 65 and older. For adults aged 19 to 64, routine eye exams are not covered unless deemed medically necessary. The plan does not cover prescription glasses or contact lenses. Learn more about eye exam coverage.

Hospital

Under the Alberta Health Care Insurance Plan (AHCIP), residents are covered for standard accommodations and meals during hospital stays. This includes basic ward rooms and medically necessary services. Private or semi-private rooms are not covered, but may be available for an additional fee. Learn more about hospital stays.

Paramedicals

Alberta Health Care Insurance Plan (AHCIP) does not provide coverage for services offered by chiropractors, acupuncturists, massage therapists, homeopaths, nutritionists, psychologists, physician assistants, or nurse practitioners. However, Alberta seniors enrolled in the Coverage for Seniors health benefit may be eligible for chiropractic and psychological services. Coverage for podiatric services and appliances is available, up to a set rate per person, per benefit year. Private insurers cannot cover paramedical services until the Alberta government’s yearly maximum has been reached.

Hearing aids

The Alberta Aids to Daily Living Program provides limited coverage for hearing aids and other medical devices for residents who are disabled, chronically ill, or terminally ill. Coverage includes hearing devices and some related medical supplies. Eligibility is based on medical need, and additional assistance may be available depending on the individual’s circumstances.

Medical equipment & supplies

The Alberta Aids to Daily Living (AADL) Program provides limited coverage for medical supplies and devices, including hearing aids and other necessary equipment, for residents who are disabled, chronically ill, or terminally ill. Continuous Glucose Monitors (CGMs) are covered for individuals aged 18 and under who meet specific eligibility requirements. Coverage for other medical supplies, such as ostomy supplies or orthoses, may also be available depending on medical need and eligibility criteria.

Paramedicals

Alberta Health Care Insurance Plan (AHCIP) does not provide coverage for services offered by chiropractors, acupuncturists, massage therapists, homeopaths, nutritionists, psychologists, physician assistants, or nurse practitioners. However, Alberta seniors enrolled in the Coverage for Seniors health benefit may be eligible for chiropractic and psychological services. Coverage for podiatric services and appliances is available, up to a set rate per person, per benefit year. Private insurers cannot cover paramedical services until the Alberta government’s yearly maximum has been reached.

Nursing benefits and home care

Continuing care services and home care in Alberta are based on individual needs. If you qualify, the Alberta government provides coverage for various services delivered in your home or community, including personal care, nursing, and support services. Coverage is determined by an assessment of your healthcare requirements.

Accidental death and dismemberment

The Alberta Health Care Insurance Plan (AHCIP) does not provide any coverage for accidental death and dismemberment. Residents seeking this type of coverage will need to explore private insurance options.

Out of country

The Alberta Health Care Insurance Plan (AHCIP) provides limited coverage for physician services outside of Canada, reimbursing up to Alberta rates only. Hospital services are covered if they are medically necessary and performed in a hospital setting. However, ambulance services outside of Alberta are not covered, and services provided in private healthcare facilities are also excluded. The cost of any services beyond Alberta's rates is the responsibility of the resident.

Disclaimer

The information provided on this page is intended for general informational purposes only and may be subject to change. While every effort is made to ensure accuracy, provincial and territorial health coverage details can vary and are regularly updated. We recommend contacting your respective GHIP or consulting a legal, tax, or insurance advisor for advice tailored to your specific situation.

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Extended Health Care

How Personal Health & Dental Insurance Complements Your Provincial Plan

While your provincial or territorial health plan covers many essential medical services, there are important areas where personal health insurance can help extend your coverage, giving you broader protection and peace of mind.

Bridge the Gaps in Coverage

Provincial health plans often leave gaps, such as prescription drugs, dental visits, and vision care. Personal health insurance can bridge these gaps by covering expenses your government plan doesn’t, ensuring you’re not left with unexpected out-of-pocket costs.

Be Ready for Life’s Health Changes

Even with your government health coverage, there are still costs that can catch you off guard, like prescription drugs, dental care, and vision expenses. A personal health plan can step in to cover these out-of-pocket expenses, making sure you’re protected from financial surprises.

Secure Your Health & Financial Future

Investing in personal health insurance today can save you from paying high costs for treatments or services down the road. By taking a proactive approach, you can ensure you get the care you need now, avoiding bigger health issues—and bigger bills—later on.

Get in touch

Talk to an advisor who can understand your situation, answer your questions and help you build an insurance plan appropriate for you and your family.

How to contact your GHIP

For more information on the latest coverage details, please contact the Alberta provincial health care plan directly at:

Alberta Health Care Insurance Plan
P.O. Box 1360 Station Main
Edmonton, AB T5J 2N3
In Edmonton: 780-427-1432
Toll-free: 1-800-310-0000
Email: [email protected]

Website: Alberta Health Care Insurance Plan