The Province of Alberta provides its residents full coverage for healthcare services of physicians and dental and oral surgical services that are medically necessary under the Alberta Health Care Insurance Plan. It is only available to eligible residents. Whether the procedure is medically necessary or not, and hence if it is unsure or not, is determined by your physician. 

Eligible Residents for Alberta Health Care Insurance.

To qualify for medical insurance under The Alberta Health Care Insurance Plan, you must satisfy the eligibility criteria mentioned below. 

  • You must be legally allowed to be and remain in Canada. 
  • You must make Alberta your primary home. 
  • You must be in Alberta for 183 days out of 12 months.
  • You must not be receiving coverage or claiming medical insurance under the insurance plans of another province. 
  • You must also not be a primary resident of another province.  
  • You must not be a visitor or tourist in Alberta or a temporary resident of Alberta. You must also not have been denied residence in Alberta in the past. 

If you are moving to Alberta from a different country, you need to have your immigration documents from Immigration Refugees Citizenship Canada. Then you may be eligible for Alberta Health Care Insurance Plan medical coverage depending on the type of Immigration, restrictions on your Visa, duration of your stay in Canada and the willingness to reside in Alberta province for 12 months at a time. 

The authorities of the insurance program will review all documentation submitted including applications, Canada entry, temporary resident visas and permanent residence permits before determining if you are eligible for medical insurance under this plan. 

If you move to Alberta from another Canadian province, you will have to wait for the duration of the waiting period applicable before coverage begins for you. If you come to Alberta from outside Canada, you must have your immigration documents from the Immigration Refugees Citizenship Canada to apply for the Alberta Health Care Insurance Plan. 

Non-eligible Residents 

If you are one of the residents listed below, you are not eligible to apply for medical and healthcare insurance under the Alberta Health Care Insurance Plan. 

  • If you are a serving or ex part of Canada’s Armed Forces.  
  • If you are an inmate in the federal penitentiary system.
  • If you have refugee claims.
  • If you have failed or refused refugee claims. 
  • If you have immigration documents that have expired.

The Federal Government provides coverage to the members of the Canada’s Armed Forces as well as the inmates of the penitentiary system. However, dependents of the non-eligible residents can become beneficiaries of the Alberta Health Care Insurance Plan if they reside in Alberta. 

Children of refugee claimants or those who have been refused refugee claims or the children of those with expired immigration documents can gain coverage under AHCIP. The children must be Canadian, they must reside in Alberta and they will be required to meet certain eligibility criteria. 

Dependants

According to the Alberta Health Care Insurance Plan, the following fall under the category of dependants. 

  • Married spouses are required to register for the program together.
  • Separated spouses can register for the insurance together or separately. 
  • Divorced spouses can register separately. 
  • Adult independent partners can register for medical insurance together or separately.
  • Children who are single, and under the age of 21, wholly dependent on their parents, adopted children and foster children included are also considered as dependants.
  • In case there is a divorce, children who are in the care of the court will be registered for the program by the custodial parents.
  • In case there is joint custody of a child, or children who are under the care of anyone parent and not both are also dependants.
  • The dependant category also covers children who are above the age of 21 but completely dependent on their parents due to being physically or mentally differently-abled. 
  • A single child, a full-time student at an authorized educational institution, under the age of 25 also comes under the dependant’s category. 

How to apply for Alberta Health Care Insurance.

Step 1

Carefully complete the application form for the AHCIP Coverage. You can also apply for this insurance for your child who is a Canadian, you are their parents, and you are present in Alberta, but not eligible yourself to apply for this insurance. You can download a copy of the form from an authorized registered website or receive it from an eligible agent.

Step 2

Listed below are the supporting documents you will need while applying for AHCIP Coverage. 

  • You must have proof that you reside in Alberta. These can be in the form of your driver’s license, bills for utilities or electricity paid in Alberta, mortgage documents, rent documents, house insurance, or documents of the registration of your vehicle in Alberta. 
  • You must have proof of identity. These can be your Canadian passport, your permanent resident card, driver’s license, Canadian citizenship card, Alberta registries ID card, or First Nations or Inuit card. 
  • You will require the documents showing you are legally allowed to be in Canada. Your Canadian passport, a document of Canadian entry, birth certificate from Canada, permanent resident card, or your Canadian citizenship documents can be used. 

If these documents are not submitted, the authorities can reject your application. If any additional documents are needed, you will be requested to send them. 

Step 3

You can submit your application form in person or via mail. To submit it in person, you will have to take your application form along with the original documents to a registry agent who is authorized. This service is offered at no charge. The processing time of your application is estimated to be around 5 days. 

If you wish to utilize the option of mailing services, you will have to send the completed application along with the supporting documents.

It is advised that you send all the required documents in the form of photocopies, front and back unless the original is required. Processing time is estimated to be around 6 weeks. 

Medical Services Covered in Alberta Health Care Insurance

Listed below are the medical services covered by the AHCIP. 

  • Services of a physician that are medically necessary. 
  • Visits to the psychiatrist.
  • Diagnostic services like lab work, radiology, or other procedures. 
  • Oral and maxillofacial surgeries. 
  • Bariatric surgeries of eligible Alberta residents under the Weight Wise Program. 
  • Augmentation of breasts and mastectomy for transgender surgeries.
  • Visits and stays in a hospital. 

Listed below are the hospital services that are covered under this plan.

  • Nursing services that are medically necessary.
  • Lab work, x-rays, and other diagnostic procedures. 
  • Standard accommodations and meals.
  • Medicines are given in the hospital.
  • Operating room, care room, radiotherapy, physiotherapy charges, and anesthetics. 
  • Cost of the surgical equipment used.
  • Ambulance charges. 

Partially Covered Services by AHCIP.

Partial coverage is given under AHCIP for certain podiatry and optometry services given in Alberta. 

Optometry (vision)

Listed below are the optometry services that have partial coverage in Alberta but not outside the province. 

  • For children below the age of 18 and elders above the age of 65 get coverage for one full eye examination, one partial examination and one diagnostic procedure every year, mostly between 1 July and 30 June. 
  • Full coverage is given for certain medical procedures to treat certain conditions by optometrists. 
  • You will not have to pay your optometrist for treatments and procedures that are covered under the AHCIP. However, if any additional costs arise during these, they will be payable by you. 
  • If you are between the ages of 19 and 65, you will receive full coverage for eye examinations that are considered medically necessary by your optometrist due to trauma or a pre-existing condition. 

Dental (oral)

Listed below are the dental services that will receive partial coverage. 

  • Coverage is provided for specified dental, oral and maxillofacial surgeries. 
  • Some services in oral maxillofacial.

Podiatry (foot care)

Listed below are the podiatry services covered in Alberta by not outside Alberta. 

  • Partial coverage is given for basic podiatry services. 
  • Services of a pediatric surgeon are fully covered under the AHCIP. 
  • Services of surgeons in hospitals and clinics are also covered. The cost of the surgical facility, if it is in contract with Alberta Health Services, is also covered. 

Services Not Covered by AHCIP. 

Some services are not covered by the AHCIP in or outside Alberta.

Medical services not covered.

Listed here are some of the medical services for which coverage is not given under the AHCIP. 

  • Non-medical surgeries like cosmetic surgeries, vasectomy reversals and abdominoplasty are not covered.
  • Medical advice given over the phone is not covered unless it violates the Schedule Medical Benefits or the Schedule of Oral and Maxillofacial Surgery Benefits. 
  • Services of a care provider other than those of a physician.
  • Eye Care, including eye examinations, surgery, glasses and contact lenses.
  • Routine dental care like cleaning, fillings, extraction of wisdom teeth and dentures. 
  • Prescription drugs provided at somewhere other than a hospital.
  • Vaccinations for travelling. 
  • Fertility treatments, in vitro fertilization and other assistive reproductive technologies.
  • Medical forms and notes.
  • Services of a psychologist.
  • Medical exam for a driver’s license.

Hospital services not covered

Here are some of the hospital services that do not have coverage under the AHCIP.

  • Hospital rooms that are private or semi,-private.
  • Services of an ambulance.
  • Charges for anesthetics.
  • Experimental procedures or those procedures that are undergoing clinical trials.

Services Not Covered Outside Alberta

Here are the services not covered outside Alberta. 

  • Vision care.
  • Services for mental health and addiction.
  • Physiotherapy.
  • Services of a midwife.
  • Services for cancer.
  • Home care services.
  • Podiatry and optometry.
  • Dentist services that are not medically necessary.