Non-Group coverage

Non-Group coverage is a drug benefit program available to all residents of Alberta under the age of 65 and their dependants. Non-Group coverage is premium-based coverage providing access to supplementary prescription drugs not covered by the Alberta Health Care Insurance Plan (AHCIP).

Alberta Blue Cross administers the Non-Group Coverage plan on behalf of Alberta Health. Coverage is automatically provided for all individuals listed under the same AHCIP account.

To qualify for this plan, you must be:

  • A resident of Alberta
  • Under the age of 65 years
  • Registered with the AHCIP 
  • Not in arrears (not owing past premiums).

Apply for coverage

Coverage will begin on the first day of the fourth month after Alberta Health receives your application. If you are leaving a existing supplementary health plan, provide Alberta Health with a completed application within 30 days of your previous coverage ending to ensure continuous coverage.

To cancel Non-Group Coverage, Alberta Health must be notified. Coverage will be cancelled the last day of the month in which notification is received.

Benefits covered under this plan

  • A $50 annual deductible is applied to the total of all eligible health benefit expenses incurred in a benefit year, except for prescription drugs and diabetic supplies.

Prescription drugs

A co-payment is required for each prescription. A co-payment is the portion of the prescription cost you pay to your pharmacy when you have a prescription filled.

  • The co-payment is 30% to a maximum of $25. You will not pay more than $25 for most prescriptions.
  • Prescription drugs covered under the plan are listed in the Alberta Drug Benefit List.

There are a few cases when you might have to pay more than the $25 co-payment maximum:

  • If your drug is not listed in the Alberta Drug Benefit List
  • If you want a more expensive brand of drug than the least cost alternative or generic product, or
  • If the brand of drug you want costs more than the maximum cost set by Alberta Health for that drug.

Before your prescription it is filled, ask your pharmacist about the cost of the drug.

Diabetic supplies

Diabetic supply coverage is for insulin-treated diabetics only. Up to a maximum of $600 per eligible person each benefit year is covered for diabetic supplies purchased from a licensed pharmacy. Diabetic supplies include needles, syringes, lancets, and both blood glucose and urine testing strips.

Ambulance services

Coverage for ambulance services are up to the maximum rate established by Alberta Health for transportation to or from a public, general, active treatment hospital in the event of illness or injury. Transportation must be provided in a ground vehicle licensed under the Emergency Health Services Act and regulations. It does not include inter-facility transfer by ambulance.

Clinical psychological services

Coverage for clinical psychological services are up to $60 per visit, to a maximum of $300 per family each benefit year, for treatment of mental or emotional illness by a registered chartered psychologist.

Home nursing care

Coverage for home nursing care is up to $200 per family each benefit year for nursing care provided in the patient’s home by written order of a physician. Home nursing care must be provided by a registered nurse or licensed practical nurse who is not a relative of the patient.

Prosthetic and orthotic benefits

Coverage for prosthetic and orthotic benefits is up to 25% of the maximum allowable amount for items included on the benefit list as defined by Alberta Health. Coverage includes the purchase or repair of artificial eyes, prosthetic devices (except myoelectric-controlled prostheses) and braces required for six months or longer. A physician’s written order is required. Foot orthotics are not included as a benefit.

Mastectomy prosthesis

Coverage for mastectomy prostheses is up to 25% of the maximum allowable amount for the mastectomy prosthesis included on the benefit list as defined by Alberta Health. This does not apply to the purchase of a supporting brassiere.

Hospital accommodation

In a publicly funded active treatment hospital, you are covered for the difference in cost for a private or semi-private hospital room. Show your Alberta Blue Cross card when you are admitted, as all Alberta hospitals bill Alberta Blue Cross directly.

How to claim for benefits