Drug coverage and supplementary health benefits

Supplementary health benefits

The Alberta government provides supplementary health benefits for eligible Albertans. Knowing what is covered can health you make informed decisions on the drug and health benefits coverage you need, and make the best use of our health system.

There are 18 drug and supplementary health benefits programs offered by different government of Alberta ministries which are being consolidated and streamlined. The goal is to have a comprehensive drug and supplementary health benefits program that serves the needs of Albertans and is financially sustainable.

The government-sponsored supplementary health benefit plans include: coverage for prescription drugs, diabetic supplies, ambulance services, chiropractic care, clinical psychological services, dental, optical and hospital accommodation assistance. These supplementary health benefits also include programs that provide financial assistance to Albertans with a long-term disability to buy medical equipment and supplies.

Prescription drug coverage

Drug prices are among the highest cost drivers in health care and action must be taken to manage those costs. Alberta continues to work with our federal, provincial and territorial counterparts to lower drug prices for Albertans by supporting national drug pricing negotiations and providing appropriate access to drugs to achieve long-term stability. Alberta Health is shifting from a dispensing fee approach to include a professional services model where customers can receive even more services from their pharmacist.

Albertans are responsible for the cost of prescription drugs provided to them outside hospitals, auxiliary hospitals and nursing homes.

Many Albertans have insurance coverage for prescription drugs provided through supplementary health plans sponsored by their employers. Others have coverage through publicly-funded plans offered by the provincial or federal governments. There are Albertans who have no insurance coverage and pay for prescription drugs themselves.

  • Alberta Health recommends that all Albertans obtain and maintain insurance coverage for prescription drugs.

Prescription quantities

Alberta Health places no limitation on the quantities of drugs that may be prescribed. Prescribers exercise their professional judgment in determining the course and duration of treatment for their patients. In most cases, Alberta Health will not pay benefits for more than a 100-day supply of a drug at one time.

Once the medical therapy of the patient is in the maintenance stage, unless there are circumstances that require smaller quantities to be dispensed, dispensing should be for a 100-day supply.

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