Alberta Health Care Insurance Plan (AHCIP): 2024 guide

Alberta Health Care Services, under the Alberta Health Care Insurance Plan (AHCIP), is responsible for providing essential medical care, including doctor visits and hospital stays, to eligible Alberta residents. The AHCIP covers medically necessary services to ensure residents have access to critical health care.

But how does the AHCIP work? What does it cover? Are you eligible? Is it enough or should you get private insurance? Find out all this information and more in this comprehensive guide on AHCIP.

What is Alberta Health Care?

Alberta Health Services (AHS) is an integrated health system that is responsible for delivering health care services to Alberta residents, as well as to some residents in Saskatchewan, B.C. and the Northwest Territories. It provides several essential health services to Albertans, but many still choose to get private health coverage to supplement it.

The Alberta Health Care Insurance Plan, or AHCIP, is the publicly administered and funded health care program run by AHS. It provides residents with access to medically necessary hospital and health care services. It covers health care costs such as doctor-provided medical services, diagnostic services (x-rays, lab tests, etc.) and hospital accommodation.

What is the Alberta Health Care Card?

The Alberta Health Care Card is an identification card issued to eligible Alberta residents who are covered under the AHCIP. It serves as proof of enrollment in the provincial health insurance plan and allows residents to access publicly funded healthcare services in Alberta.

This is what an Alberta Health Care Card looks like:

The card contains essential information, including the individual's name, unique nine-digit Alberta Health Care number, date of birth, and the card's expiry date (if applicable). The card is usually teal-coloured and has the Alberta Health logo on it.

With the Alberta Health Care Card, individuals can visit doctors, specialists, hospitals, and other healthcare providers without having to pay out-of-pocket for medically necessary services covered by the AHCIP.

It's important to keep the card safe and present it whenever you seek medical services in Alberta, as it verifies your eligibility for publicly funded healthcare. If you lose your card or have some damage, you can request a replacement for the lost Alberta health care card.

How to get a new Alberta Health Care card?

Here are quick steps to help you apply for a new Alberta health card.

Gather Documents: Ensure you have proof of identity, Alberta residency, and legal entitlement to live in Canada (e.g., passport, permanent resident card).

Choose Application Method:

• Online: Apply through the Alberta Health website by uploading digital copies of your documents.
• Mail: Download the application form, complete it, and mail it with photocopies of your documents.
• In-Person: Visit a local registry agent office with your original documents.

Submit Your Application: Depending on your chosen method (online, by mail, or in person), submit your completed form and documents.

Receive Your Health Card: After processing, your new Alberta Health Care card will be mailed to your provided address.

How does Alberta Health Care card replacement work?

1. Report Lost or Damaged Card: Call Alberta Health at 1-800-232-7215 or visit a registry office to report your lost or damaged card.
2. Verify Your Identity: Provide your personal details, such as name, date of birth, and Alberta Health Care number, to confirm your identity.
3. Pay Any Fees (If Applicable): You may need to pay a replacement fee. However, this fee may be waived if your card was stolen and you provide a police report.
4. Receive Your Replacement Card: Once processed, your replacement Alberta Health Care card will be mailed to your registered address.

What is my Alberta health care number?

Your Alberta health care number is a nine-digit number unique to you and you can find it on your health care card. This Alberta health care card number is how doctors and hospitals will confirm your enrolment in AHCIP. It will also allow you access to your medical records. 

If you need help finding this number, you can find it on the teal-coloured strip on your health care card. You can also call 780-427-1432 (Dial 310-0000 first for toll-free calling within Alberta) or visit their website for further assistance.

What does Alberta health care cover?

AHCIP provides eligible Alberta residents with full coverage for some medically necessary physician services, and dental and oral surgical health services. Your physician will determine what insured services are considered medically necessary.

• Physician visits
• Psychiatrist visits
• Diagnostic services including laboratory, radiological (x-rays)
• Oral and maxillofacial surgery services
• Bariatric surgery for Albertans who are eligible under the Weight Wise program
• Breast augmentation and mastectomy for transgender surgery
• Hospital visits and stays
• Nursing services
• Medications during hospital stay
• Operating room, care room, radiotherapy, physiotherapy and anesthetic facilities
• Inter-facility transfer in Alberta by ambulance

The AHCIP provides partial coverage for podiatry, optometry, and some specialized dental services only in Alberta. These services have benefit limits or maximums per benefit year.

Service type	Coverage
Optometry	Children 18 years old and under, and seniors 65+ years are eligible for 1 complete eye exam, 1 partial exam and 1 diagnostic procedure per benefit year full coverage, if you are 19 to 65 years old, for an eye exam your optometrist deems is medically necessary as a result of trauma, a medical condition or an episode of illness *Optometrists cannot charge you for services covered by AHCIP, but you are responsible for additional costs incurred at the time of treatment.
Dentistry	some specific dental, oral and maxillofacial surgical services
Podiatry	Partial coverage for some podiatry services, to a maximum of $250 per benefit year

When the charge for a dental, optometry, or dentistry service exceeds the benefit limit, you must pay the difference in cost. These services can be expensive which can lead to unforeseen financial stress. We strongly recommend that you obtain private health care in Alberta to avoid unexpected out-of-pocket costs. 

While looking for a good health insurance plan might be time-consuming, we've made it simple for you. You could use our comparator tool to get prices, coverage info, and even get free quotes based on your unique needs from the best health insurances in Canada, and in no time.

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What is not covered by Alberta Health Care?

There is a sizeable number of treatments that the Alberta Health Care Insurance Plan does not cover:

• Complementary or alternative medical treatments, such as a chiropractor, massage therapist, naturopath, nutritionist or social worker
• Psychologist and therapy
• Routine surgical equipment and supplies
• Accommodations at a standard level and meals
• Cosmetic surgery (e.g. tummy tuck), unless medically required
• Prescription medication, drugs other than those prescribed during a hospital stay
• Eye examinations for adults aged 19-64, unless medically necessary
• Eyeglasses, contacts or laser eye surgery
• Medical appliances or mobility devices, such as wheelchair
• Hearing aids
• Dental treatments
• Ambulance services unless transferred from one medical facility to another
• Most contraception

What is covered under Alberta health care for seniors?

The Alberta Health Care Insurance Plan (AHCIP) covers several health services for seniors in Alberta:

1. Physician Visits: Alberta Health Care provides coverage for medically necessary visits to physicians and specialists.
2. Hospital Services: Coverage includes hospital stays, nursing services, laboratory tests, and diagnostic procedures.
3. Oral and Maxillofacial Surgery: Coverage is provided for certain oral and maxillofacial surgical services.
4. Eye Exams: Seniors are eligible for coverage for eye exams.
5. Specific Medical Conditions Treated by Optometrists: Coverage includes treatment for certain medical conditions provided by optometrists.
6. Dental Services: Routine dental care is not covered for adults, but some specific dental, oral, maxillofacial surgical services may be covered for seniors.

It's important to note that AHCIP does not cover certain health services, such as prescription drugs outside of hospital stays, eyeglasses, hearing aids, cosmetic surgery, and most dental treatments.

Is there Alberta Health Services home care for seniors?

Alberta Health Services offers home care services for seniors. Home care services include personal care assistance, medication management, nursing care, and rehabilitation services.

AHS also provides specialized care for seniors with chronic conditions or palliative needs. Home care assessments are conducted by healthcare professionals to determine individual care plans.

These services are generally covered by the AHCIP as it provides coverage for medically necessary healthcare services, and home care for seniors falls under this category when it is deemed necessary to support their health and well-being.

Does Alberta Health Care cover dental?

Unfortunately, it largely does not. Even worse, Alberta has some of the highest dental fees in Canada. Alberta Health does not pay for routine dental care such as cleanings, fillings and wisdom teeth removal. Nor does it cover dentures.

Wondering how much dental implants cost in Alberta? Or what you could expect to pay for a dental cleaning? This information and much, much more is available in the Alberta Dental Fee Guide. The Alberta Dental Association and College produce annual guides for services from generalists and specialists.

While the listed fees are suggestions rather than required, the guide has been successful in bringing transparency to Albertans and helped lower prices. Always check with your service provider before getting treatment or surgery to confirm.

You can download the Alberta dental fee guide for 2024 here:

Dental care can be quite expensive if you have to pay out of pocket, but private health care in Alberta can help you cover a significant percentage of these costs. If you would like to explore health insurance options, you could simply use our comparator and get quotes from Canada's best health insurance providers.

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How do I get Alberta Health care?

To apply for the AHCIP, you will need to complete the Alberta health care application form and submit it along with supporting documents. You can download the application here.

The supporting documentation that you will need to provide in addition to your application for Alberta health care are:

• Alberta residency
• identity
• legal entitlement to be in Canada

There are several different documents you can submit to show Alberta residency and legal entitlement to be in Canada such as:

• Proof of identity (e.g. Canadian passport, Permanent Resident Card, Alberta driver’s license)
• Proof of legal right to be in Canada (e.g. Canadian passport, Permanent Resident Card, Canada entry document, Canadian citizenship card)
• Proof of Alberta residency (e.g. Mortgage or rental agreement, utility or phone bill, home insurance policy, vehicle registration, or Alberta driver’s license)

You can submit your completed application and supporting documents either in person or by mail. If you opt to submit your application in person, you can do so by visiting an authorized registry agent. There is no charge for this service. Once you submit your application in person, the processing time will take approximately 5 days. You will receive your card in the mail.

For mail-in application, send the application and photocopies of your supporting documents to the AHCIP office:

Alberta Health
Attention: Alberta Health Care Insurance Plan
PO Box 1360, Station Main
Edmonton, Alberta T5J 2N3

You must include photocopies of supporting documents with your application. AHCIP advises to not send original documents in the mail. If you apply by mail, processing time can take up to 6 weeks. Your coverage will start once you receive your card.

How do I renew my Alberta health care card?

Your Alberta health care card does not expire. However, if you need to make a change to your card due to a life event such as:

• change in mailing address
• change in name
• change in marital or relationship status
• have a new child or dependant
• remove a dependant who no longer qualifies to be on your account
• report a death

You can visit the Alberta health insurance plan online portal for instructions on how to update your card and services like Alberta health care change of address, phone number, and others mentioned above. 

How do I get my medical records under Alberta Health Care?

You can access your Alberta health records online via the MyHealth Records platform as well as on the MyHealth Records app on your phone.

To do so, you will need to create a MyAlberta Digital ID. Once created, you will need to verify your identity using your Alberta-issued driver’s licence or identification card. After this step, you can create your MyHealth Records account and access records (for a 90-day grace period) while waiting for a mailed verification code to complete the final step in verifying your MyAlberta Digital ID.

Once you have verified, you can go to MyHealth Records and log in with your MyAlberta Digital ID to create your MyHealth Records account. You will also need your Alberta Personal Health Number.

How do I contact AHCIP?

If you need to contact AHS, you can call the Alberta health care card phone number 1-800-232-7215. A representative will be able to help you Monday through Friday from 8:15 am to 4:30 pm.

Make sure you have your personal health number ready when you call. For general inquiries or non-personal questions, you can contact Alberta Health Services at: [email protected].

How do I change my name on my Alberta health care card?

If you need to change your name on your Alberta Health Care card, you will need to complete the Name/Address form. You can download the form here and fill it out carefully to ensure all your details are as per the official documents that you will be providing for your application.

Once you have completed the form, you can take it to an authorised registry agent office or you can mail the form to:

Alberta Health
Attention: Alberta Health Care Insurance Plan
PO Box 1360, Station Main
Edmonton, Alberta T5J 2N3

How long can you be out of Alberta to get AHCIP services?

There is no specific time limit on how long you can be out of Alberta to maintain your eligibility for the AHCIP. However, it's essential to note that you must be physically present in Alberta for at least 183 days in any 12-month period to be considered an eligible resident.

If you are absent from Alberta for an extended period, your AHCIP eligibility may be affected if Alberta Health determines you are no longer a resident. For instance, if you establish residency in another province or country, you may lose your eligibility.

How does out-of-province Alberta health care work?

If you are an Alberta resident and need health care services while travelling or temporarily living in another Canadian province or territory, you will typically have coverage through the AHCIP for medically necessary services.

Canada has reciprocal agreements among provinces to provide basic, medically necessary health care services to residents of other provinces. These agreements ensure that you will be eligible for essential health services while outside Alberta.

Your coverage will be limited to medically necessary services, which are typically services that are essential for maintaining health, preventing illness, or treating a medical condition. While out-of-province coverage is provided for medically necessary services, it is a good idea to consider purchasing additional travel insurance.

Additional Health Services Under Alberta Health Care

Does Alberta health care cover eye exams?

AHCIP coverage does not generally include routine eye exams for adults aged 19 to 64 years. The AHCIP does not consider eye exams for adults in this age group as medically necessary procedures or tests.

However, there are specific exceptions to this rule:

1. Children (aged 18 and under) and seniors (aged 65 and older) in Alberta are eligible for one complete eye exam, one partial exam, and one diagnostic procedure per benefit year.
2. Adults aged 19 to 64 years may be eligible for a fully covered eye exam if it is deemed medically necessary by an optometrist due to trauma, a medical condition, or an episode of illness.

Are hearing tests covered by Alberta health care?

Hearing tests are not generally covered by the AHCIP for adults aged 19 to 64 years. Hearing tests are considered an elective service and are not typically deemed medically necessary under AHCIP.

However, there are exceptions to this rule:

1. Children (aged 18 and under) may be eligible for fully covered hearing tests if they meet specific criteria related to their hearing health.
2. Seniors (aged 65 and older) in Alberta may have access to hearing tests through AHCIP, as part of the government's commitment to supporting the health needs of seniors.

Is functional medicine covered by Alberta health care?

Since functional medicine is considered an alternative or complementary approach, it is generally not covered by provincial health insurance plans like AHCIP. Individuals interested in functional medicine services may need to pay for these services out-of-pocket.

Private health insurance plans may offer coverage for some alternative health services, so it's worth checking with your insurance provider to understand your coverage options.

Is dermatology covered by Alberta health care?

Dermatology services are generally covered by the AHCIP when provided by a medically licensed dermatologist as part of the publicly funded healthcare system.

AHCIP provides coverage for medically necessary dermatological consultations and treatments, such as:

1. Evaluation and management of skin conditions, including rashes, acne, eczema, psoriasis, and skin infections.
2. Skin cancer screenings and treatments.
3. Biopsies and excisions of suspicious skin lesions.
4. Management of chronic skin conditions.

Please note that some specific dermatological services, such as cosmetic procedures or elective treatments, may not be covered by AHCIP and you may require to pay out-of-pocket.

Is there Alberta Health Services foot care?

Yes, AHS offers foot care services for eligible individuals in Alberta. Foot care is an essential part of overall health, particularly for those with foot-related medical conditions or mobility challenges. AHS provides foot care services through various healthcare providers, including nurses, podiatrists, and foot care specialists.

It's important to note that foot care services provided by AHS may be limited to medically necessary foot care. The AHCIP typically does not cover cosmetic or elective foot care, such as pedicures, and may require you to pay out-of-pocket for these expenses.

Does Alberta health care cover physiotherapy?

It coverage does not typically include physiotherapy services. Physiotherapy is considered an elective service and is not generally deemed medically necessary for all patients under AHCIP.

However, there are some specific exceptions and situations where AHCIP may provide coverage for physiotherapy:

1. Hospital Inpatients: Physiotherapy services provided to patients admitted to a hospital may be covered by AHCIP as part of their hospital stay.
2. Post-Hospital Discharge: AHCIP may cover a limited number of physiotherapy sessions for patients who are discharged from a hospital, depending on their medical needs and conditions.
3. Specific Medical Conditions: In certain cases, individuals with specific medical conditions or injuries may be eligible for physiotherapy services. The eligibility is typically determined based on medical necessity and the individual's condition.
4. Alberta Aids to Daily Living (AADL) Program: The AADL program, which is separate from AHCIP, may provide coverage for physiotherapy equipment or assistive devices related to physiotherapy needs.

Given that several of these uncovered services could be quite a financial burden, it's highly advisable to get a good health insurance plan that is tailor-made to your unique needs. You don't need to look further but just use our comparator to get prices, coverage, and quotes from the best health insurance in Canada in no time.

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Why you should know the Alberta health care aide directory?

The Alberta Health Care Aide Directory serves as a central resource for information, news, and updates about Health Care Aides (HCAs) in continuing care. It confirms that HCAs in Alberta have the necessary competencies to provide safe and proficient care.

The directory educates employers, educators, stakeholders, and the public about the vital role of HCAs in healthcare. Additionally, it acts as a database for workforce planning, collecting information on HCA employment. HCAs on the directory fall into three categories: Certified, Substantially Equivalent, and Deemed Competent based on their qualifications and assessments.

The directory provides valuable information about Health Care Aides (HCAs), their qualifications, and their roles in the healthcare system. This helps the public understand the expertise and services HCAs can provide, leading to better-informed decisions regarding their healthcare needs. You can access this at www.albertahcadirectory.com.

FAQs on Alberta Health Care