Health coverage outside Canada
Coverage under the AHCIP
The AHCIP covers only limited physician and hospital costs outside of Canada. If patients receive emergency medical or hospital care while outside Canada, they will be responsible for paying the difference between the amount charged and the amount the AHCIP reimburses.
As the costs for health care services provided outside Canada can be significantly higher than in Alberta, it is strongly recommended that all Albertans purchase supplementary travel insurance to help protect against the high costs of emergency medical expenses.
If claiming coverage under the AHCIP, it is your responsibility to provide payment to the health service provider. You could then submit a claim to Alberta Health for reimbursement for eligible out-of-country health expenses. Reimbursement is issued in Canadian funds only.
Insured physician services received outside Canada are paid at the lesser of the amount claimed or the rate an Alberta physician is paid for that service.
- The services and rates paid to Alberta physicians are listed in the Schedule of Medical Benefits
The rate for in-patient hospital services is $100 (Canadian) per day, not including the day of discharge. The rate for outpatient services is $50 (Canadian) per day, with a limit of one visit per day. These hospital-services rates are the maximum that is reimbursed for all services provided to a patient, such as room and board, nursing, laboratory and X-ray services, medical supplies, and prescription drugs.
Insured hospital services must be provided in a general or auxiliary hospital. A hospital provides diagnostic services and facilities for medical and surgical treatment for urgent medical conditions and short-term treatment for a severe injury or episode of illness. Hospital services provided in a private health facility are not eligible for reimbursement.
What is not covered
The AHCIP does not cover:
- food, lodging, transportation, or other costs related to obtaining health services outside Alberta;
- health services provided by health care providers other than physicians (chiropractor acupuncturist, massage therapist, homeopath, nutritionist, psychologist, podiatrist, optometrist, physician assistant or nurse practitioner);
- air or ground ambulance services;
- mental health services not provided in a general hospital;
- publicly funded services (services in Alberta funded by Alberta Health Services) such as home care, behavioral disorders or addiction treatment;
- prescription medication;
- medical/surgical appliances, prosthetics;
- experimental or research procedures (e.g., clinical trials).
Out-of-country health services coverage
The Out-of-Country Health Services Committee considers applications for funding of insured medical, oral surgical and/or hospital services that are not available in Canada.