The provincial public health insurance in Alberta, known as the Alberta Health Care Insurance Plan (AHCIP), provides eligible residents with free coverage for basic medical services, including doctor visits, hospital stays, necessary surgeries, and certain diagnostic services.
Eligible individuals include Canadian citizens, permanent residents, accepted refugees, and those with valid work or study permits for at least 12 months who reside in Alberta on a regular basis.
Registration in this program is mandatory, and once approved, the Alberta Health Care Insurance Plan card is issued to access healthcare services. Services Provided by the Alberta Health Care Insurance Plan (AHCIP)
Prescription Drugs
- Coverage for Seniors (65 and older): Premium-free plan. Seniors pay 30% co-pay, up to a maximum of $25 per prescription. It includes coverage for diabetes supplies up to $2,400 per year per eligible person, depending on diabetes management methods.
- Family Members Under 65: As of March 1, 2020, family members under age 65 are no longer eligible under the Seniors program.
- Non-Group Coverage (under 65): Eligible residents pay 30% of prescription costs, up to $25 per prescription, plus a monthly premium:
• Full Premium – Single: $63.50 / Family: $118.00
• Subsidized Premium – Single: $44.45 / Family: $82.60
Ambulance Services
- Patients are charged only a portion of emergency health services (EHS) if billed at all.
- Seniors (65+) enrolled in the Coverage for Seniors program do not receive a bill. AHCIP pays the full ambulance cost.
Dental Benefits
- No routine dental care coverage.
- Limited coverage for specific dental, oral, and maxillofacial surgeries performed by dentists.
- Additional support may be available through the federal Canadian Dental Care Plan (CDCP).
Eye Care Services
- No routine coverage for adults 19–64 (e.g., eye exams, glasses, touch lens, and laser surgery).
- Children under 19 and seniors 65+ are eligible for one complete eye exam, one partial exam, and one diagnostic procedure per benefit year (July 1 – June 30).
- Full coverage for certain specific medical conditions treated by optometrists.
- Full coverage for medically necessary eye exams for ages 19 to 65 due to trauma or illness.
- Optometrists cannot charge for AHCIP-covered services, but patients must pay additional treatment costs.
Hospital Services
- Coverage includes standard ward rooms only.
Hearing Aids
- Covered under the Alberta Aids to Daily Living (AADL) program for assistance with long-term disability, chronic illness, or terminal illness (lasting 6+ months).
Medical Supplies
- Not covered by AHCIP.
Nursing & Home Care Benefits
- Eligibility: Must be 65+ and enrolled in the Coverage for Seniors Program.
- Coverage: Up to $200 per family per benefit year for home nursing care (prescribed by a physician).
- Care must be provided by a registered nurse or licensed practical nurse (not a relative).
Paramedical Services
- Partial podiatry coverage: Up to $250 per benefit year. Additional podiatry fees may apply.
- No coverage for services from: Acupuncturists, Massage therapists, Psychologists, Chiropractors, Homeopaths, Physician assistants, Nurse practitioners, Nutritionists.
Out-of-Country Coverage
- Limited coverage for care outside Canada:
• Up to $100/day for in-patient hospital care (excluding discharge day).
• Up to $50/day for one out-patient hospital visit.
However, it’s important to note that Alberta Health Care Insurance Plan (AHCIP) does not cover all health-related expenses. Another major drawback of the public healthcare system is the long wait times for certain procedures, especially non-emergency surgeries. As a result, many patients are forced to turn to private options or use complementary insurance that allows for quicker access to specialists and healthcare services.
In such cases, having a valid complementary insurance policy tailored to your personal or family health needs not only brings greater peace of mind but also provides crucial financial support when facing unexpected medical costs or specialized care.
At Rahimian Insurance, we rely on our specialized knowledge in the insurance field and years of experience in the Canadian market to carefully assess your situation and offer the most suitable options with the clearest terms. All you need to do is to complete and submit the form below.
