AHCIP coverage within Canada

The Alberta Health Care Insurance Plan (AHCIP) provides coverage for insured physician and hospital services in Alberta and elsewhere in Canada. In most cases, if you present your valid Alberta health card to an out of province medical or hospital service provider and receive insured services, there is no cost to you.

The AHCIP does not cover food, lodging, transportation, or other costs related to obtaining health services outside Alberta.

Physician services

The provinces and territories, with the exception of Québec, participate in reciprocal agreements. Out-of-province physicians will bill their own provincial health plan for insured services provided to you when you present your valid Alberta Personal Health Card.

Out-of-province physicians are not required to bill reciprocally when providing insured services to out-of-province patients. When treating you, physicians may bill Alberta Health directly, or they may choose to bill you, after which you can submit a claim to Alberta Health for reimbursement.

Alberta’s legislation and the reciprocal agreements permit reimbursement only for insured medical services, and the amounts reimbursed are paid according to the rules and at the rates established by the province that provided the services.

If you choose to have treatment at a private facility in another province, you will be financially responsible for the cost of physician services over the amount covered under Alberta’s reciprocal agreement with that province.

Hospital services

All provinces and territories participate in reciprocal hospital agreements. The hospital rates payable under legislation and these agreements are established on an annual basis.

Payment for hospital services are limited to those goods and services that if provided in Alberta would be insured services, and only covers those services if they are provided in a publicly funded hospital. Reimbursement for private-facility fees, goods, or services (such as private MRIs) is not permitted.

If you choose to have treatment at a private facility in another province, you will be financially responsible for the facility fees.