Coverage for Seniors benefit

Premium-free benefit administered by Alberta Blue Cross

Alberta Health offers seniors, their spouses/interdependent partners and dependants registered on the same account (if applicable) a premium-free benefit to provide coverage for prescriptions and other health-related services not covered by Alberta Health Care Insurance Plan (AHCIP).

  • Alberta Blue Cross administers the program coverage and claims.
  • Alberta Health manages eligibility and registration.

Travelling?

The Coverage for Seniors Benefit does not provide travel insurance.

  • If you are planning to travel outside of the province or country, it is strongly recommended you purchase travel insurance to cover emergency hospital and medical expenses.

Qualifying for premium-free coverage

Proof of age

To be registered for Coverage for Seniors, seniors must provide proof of being 65 years of age or older. Acceptable proof-of-age documents include:

  • birth certificate
  • old-age pension entitlement form
  • passport or immigration record
  • Canadian citizenship certificate

Register

  • If Alberta Health has a proof-of-age document on your AHCIP file, Alberta Blue Cross Coverage for Seniors is automatically added to your AHCIP account.
  • If Alberta Health does not have a proof-of-age document on your AHCIP file, you will need to submit one of the documents outlined above.
  • When our records indicate an Albertan will be turning 65, a package is mailed to the address on their AHCIP file providing information about programs and services for seniors.
    • This package will include a letter asking you to submit proof-of-age documents if required.
    • If you did not receive this package or have further questions contact Alberta Health.

Benefits covered under this plan

Prescription drugs

Prescription drugs listed in the Alberta Drug Benefit List are covered. The co-payment (the portion of the prescription cost you pay to your pharmacy when you have your prescription filled) is 30% to a maximum of $25. For most prescriptions, you will not pay more than $25 for each prescription.

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, or
  • 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.

To avoid surprises, ask your pharmacist about the cost of your prescription before it is filled.

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

Seniors, age 65 and over, enrolled in the Coverage for Seniors program do not receive a bill for ambulance services. Alberta Health pays the complete cost of ambulance services.

Ambulance service charges 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 are covered. Transportation must be provided in a ground vehicle licensed under the Emergency Health Services Act and regulations. It does not include interfacility 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 patientís 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.

Chiropractic services

Coverage for chiropractic services is up to $25 per visit to a maximum of $200 per person each benefit year. The chiropractor must be a licensed Alberta practitioner.

Dental and optical assistance

Find out more about Seniors Dental and Optical Assistance

What is not covered

The following are not covered under the program:

  1. Claims for benefit expenses incurred prior to the effective date of coverage.
  2. Claims for benefit expenses received by Alberta Blue Cross more than 12 months after the service was provided.
  3. Services covered by the Alberta Health Care Insurance Plan (AHCIP).
  4. Charges for drugs supplied directly and charged for by a physician, with the exception of allergy serums.
  5. Registration, admission or user fees charged by a hospital.
  6. Drug products not listed in the Alberta Drug Benefit List. Ask your pharmacist and/or physician if your prescribed medication is on this list.
  7. Semi-private or private hospital room.
  8. Travel insurance for emergency hospital and medical expenses outside of the province or country.

How to claim for benefits / Contact information

More information