Alberta (AB)
Alberta Health Care Insurance Plan:
Coverage Exclusions

Exclusions

The following services are not covered by the provincial plan:

• services provided by any Federal and Provincial Act
• health services that are not medically required, such as cosmetic surgery, and health services that are considered experimental
• semi-private or private accommodation at patient's request
• artificial limbs and other external prosthetics
• examinations for third parties
• ground ambulance service other than between hospitals in the same city
• mileage or practitioner travelling time
• advice by telephone
• medical-legal services
• court testimony
• preparation of reports or other documents
• group immunizations unless approved
• services by a physician to his family
• routine dental care, dentures, eyeglasses (exceptions for Seniors and other extended health benefits recipients)
• hearing aids, medical and surgical appliances and supplies, (exceptions apply through the Alberta Aids to Daily Living Program)
• drugs (exceptions apply to Seniors and recipients of Alberta Widows Pension)
• services of clinical psychologist

Optional Health Services

Eligibility

Residents registered with the Commission and not in arrears for premium payments are eligible to enrol through the Alberta Medicare Plan for supplementary coverage with Alberta Blue Cross on payment of the appropriate additional premiums.

Residents age 65 or over and their dependents, and residents who are receiving a widow's pension under the Widow's Pension Act and their dependent children are covered at no cost under Alberta Blue Cross.

Hospital

the difference in charges for standard ward accommodation and semi-private or private accommodation

an allowance up to $360 per benefit period (July 1 - June 30) to apply against the cost of preferred accommodation in an auxiliary hospital in Canada

an allowance up to $40 per day to apply against hospital charges remaining after the provincial plan has paid for insured services outside the province

payment of out-patient hospital services received outside the province after the government plan benefit has been applied

Health Services

Accumulated expenses in excess of $50 per benefit period (July 1 - June 30) are reimbursed as follows:

• Ambulance: up to $100 per benefit period (July 1 - June 30)
• Appliances: full cost of appliances, i.e. artificial eyes, limbs...
• Drugs: 70% of prescription drug costs. Patient responsible for paying 30% of cost to maximum of $25 per drug prescription.
• Home Care: up to $200 per insured for a practical or registered nurse required for home care when ordered by a physician
• Naturopaths: up to $4 per visit to a maximum of $100 per insured per benefit period (July 1 - June 30)
• Psychologists: payment up to $20 per visit to a maximum of $100 per insured per benefit period (July 1 - June 30) for services of clinical psychologists for treatment of mental or emotional illness

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