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Part of Coverage and benefits

Alberta Adult Health Benefit

Benefits are available to low-income Albertans through the Adult Health Benefit.

Canada Post service disruption

A mail services contingency plan is in place to ensure critical government mail continues to be delivered as Canada Post resumes services.

Clients can pick up January cheques on Friday, December 20, from 8:15 am to 4:30 pm and on Monday, December 23, before 10 am at a local Alberta Supports Centre. Cheques not picked up will be couriered to clients.

Third party vendors from Edmonton and surrounding area, Calgary and surrounding area, Athabasca, Grande Prairie, Lethbridge and Red Deer, may pick up cheques at a local Alberta Supports Centre on December 20 and 23. Any cheques remaining on December 23, will be sent through Canada Post. Vendor cheques from all other communities will be placed in Canada Post mail on December 18. 

Vendors may call the temporary Vendor Cheque Line at 780-638-4547, or toll free at 1-855-415-0516. Hours of operation are 8:15 am to 4:30 pm, Monday to Friday. This line will not be operational over the holiday closure from Tuesday, December 24, 2024, to Wednesday, January 1, 2025.

To avoid any future payment delays, Albertans receiving benefits via cheque are encouraged to contact AISH or Income Support staff, or the Alberta Supports Contact Centre, to arrange for direct deposit.

Overview

The Alberta Adult Health Benefit program covers health benefits for Albertans in low-income households who are pregnant or have high ongoing prescription drug needs. This health plan includes children who are 18 or 19 years old if they are living at home and attending high school.

Your children may be eligible for health benefits through the Alberta Child Health Benefit program.

This program provides coverage for:

  • dental care
  • prescription drugs
  • eye exams and glasses
  • essential diabetes supplies
  • emergency ambulance services
  • essential over-the-counter medications

Coverage through other benefits plans

If you or other household members have coverage through another health benefits plan, you must use that plan first. The Alberta Adult Health Benefit plan may cover your remaining costs. Talk to your dental provider, optical provider or pharmacist about how this works.

Clients leaving the Income Support or Assured Income for the Severely Handicapped (AISH) programs may be eligible for health benefits coverage if they have household income from employment, self-employment or Canada Pension Plan Disability (CPP-D) benefits.

What is covered

Talk to your doctor, dental provider, optical provider or pharmacist to learn what is paid for by this health benefit plan.

  • Dental care

    • Basic services like extractions, fillings and dentures
    • Preventative care like x-rays, examinations and teeth cleaning are also covered

  • Eye exams and glasses

    • An eye exam and eye glasses for adults every 2 years
    • Eye glasses each year for dependents up to 18 years of age

  • Prescription drugs

    • The list of eligible prescription drugs can be found here:
    • Some over-the-counter products, such as prenatal vitamins for expectant mothers and children’s vitamins
    • Your family doctor or pharmacist has a list of what is covered under this health benefit plan

  • Ambulance services

    • Emergency ambulance trips to the nearest hospital

  • Diabetes coverage

    • Diabetes supplies such as injection supplies, testing strips and lancets
    • Plan members with diabetes will receive coverage for blood glucose test strips purchased from a licensed pharmacy, up to a maximum of 3000 per eligible person depending on the method of diabetes management. The benefit year for diabetes coverage is from July 1 to June 30. (Read the Coverage Maximums for Diabetes Supplies fact sheet).
    • Continuous Glucose Monitors (CGMs) are available to Albertans living with diabetes who meet certain eligibility criteria. See the CGM Fact Sheet for more information about CGM coverage and eligibility criteria.
      • The use of a CGM reduces or eliminates the need for blood glucose test strips. Albertans who receive funding for a CGM will have adjusted limits for blood glucose test strips, which will still provide for occasional use. Albertans who do not receive funding for a CGM will continue to have the same limits for blood glucose test strips. See the Coverage Maximums for Diabetes Supplies fact sheet for more information.

Eligible applicants

You may be eligible if you:

To be eligible for the Alberta Adult Health Benefit, you and members of your family must:

Your total net household income must fall below these maximum income guidelines based on family size.

Table 1. Maximum income guidelines based on family size

FamilyMaximum income
Single adult$16,580
1 adult + 1 child$26,023
1 adult + 2 children$31,010
1 adult + 3 children$36,325
1 adult + 4 children*$41,957
Couple, no children$23,212
Couple + 1 child$31,237
Couple + 2 children$36,634
Couple + 3 children$41,594
Couple + 4 children*$46,932

*For each additional child, add $4,973

How to calculate your income

You can calculate your income by looking at your last income tax return.

  1. Look at Line 23600 to find out your basic income.
  2. Add any child support you receive, which is on Line 15600.
  3. Subtract the amount you were taxed, which is on Line 12800.

The amount left is your income. If you have trouble calculating your income, contact us.

How to apply

Follow the steps below to complete and submit an application form. Our staff will use the information you submit to confirm eligibility for the benefit program.

Detailed directions are included in the form.

If you are leaving the Income Support or AISH program, speak to your case worker.

  1. Download the Alberta Adult Health Benefit application form AEHB3931.
  2. Read and complete all sections of the form.
  3. Sign and date the section marked My Declaration – this means that you understand everything in your application
  4. Sign and date the section titled Consent for Canada Revenue Agency to Verify Income – this gives the Alberta government permission to confirm your income with the CRA.
  5. If applicable, include documentation that demonstrates your high ongoing prescription drug needs, such as a pharmacy dispensing history report.
  6. Submit your completed application form to us by email, mail or fax.

Your information collected from this form will not be shared anywhere else for any other reason.

After you apply

  • Alberta Adult Health Benefit Card

    If you are approved, you will receive a health benefits card in the mail. The card will list the names of all eligible family members and their identification numbers.

    You need to show this card to your doctor, dental provider, pharmacist, optician or ambulance attendant each time you or a family member receives a service paid for by the Alberta Adult Health Benefit plan.

  • Annual review

    Every September, we will confirm with the Canada Revenue Agency that your household income is under the qualifying income level for your family size. If it is, your household will be automatically enrolled for another year. Children 18 and 19 years old must be still living at home and attending high school (up to grade 12).

  • Alberta Adult Health Benefit dependents

    In order for Alberta Adult Health Benefit coverage to remain active for dependent children who are 18 or 19 years old, living at home and attending high school, you must complete the following declaration form:

    Declaration of 18 and 19 Year Old Dependent form AEHB3654

  • Change of Information

    If there is a change to the applicant’s, spouse or cohabitating partner or child’s personal information, you must inform the Alberta Adult Health Benefit program area by completing the following form. Failure to update personal information may impact your eligibility for the program.

    Alberta Adult/Child Health Benefit Change of Information form AEHB3002

  • Consent to the release of information

    Applicants who wish to allow the Alberta Adult Health Benefit program to communicate with any third party (including family members, social workers or health care professional) on their behalf, you must complete the following declaration form:

    Consent to the Release of Information form AAS13391

Reassess application denial

The current benefit year is October 1, 2024, to September 30, 2025, and program eligibility is based on your 2023 income assessed by the Canada Revenue Agency.

In certain circumstances, an income reassessment can be requested if your application was denied based on the income used to determine eligibility. In order for your income to be reassessed, you must have applied.

Before you can request an income reassessment, your application must have already been denied based on your 2023 income.

  • Applying for reassessment between October 1, 2024 and February 28, 2025

    If your Alberta Adult Health Benefit application was denied between October 1, 2024, and February 28, 2025, you can apply for an income reassessment based on your estimated 2024 income. If your estimated income is projected to be below the income guidelines, you may be eligible for coverage.

    An estimated income reassessment requires the following:

    1. Income verification from January 1, 2024 to present day. This may include the following:
      • gross employment earnings (pay stub showing year-to-date income or at least 3 months’ worth of pay stubs)
      • Employment Insurance Claim Statement (My Latest Claim)
      • Canada Pension Plan or private plan benefits
      • taxable student funding (payments as listed on Notice of Assessment, not including tuition fees)
      • cashed in RRSPs
      • workers compensation benefits
      • child support payments
    2. Evidence to support your estimated income from present day up to December 31, 2024. This may include:
      • the remaining weeks of Employment Insurance you are eligible to receive
      • a current pay stub
      • a copy of a denied Income Support decision

    To apply for an income reassessment

    You must follow these steps:

    1. Complete the Request for Reassessment of Eligibility for Health Benefits form.
    2. Write a cover letter explaining your current income situation and why it differs from your 2023 income.
    3. Collect appropriate income verification/estimated income documents as stated above.
    4. Email, mail or fax all reassessment documents.

  • Applying for reassessment between March 1, 2025 and September 30, 2025

    If your Alberta Adult Health Benefit application was denied between March 1, 2025 and September 30, 2025, you can re-apply using your 2024 income as submitted to the Canada Revenue Agency. If your 2024 income is below the income guidelines, you may be eligible for coverage.

    To apply for an income reassessment

    You must follow these steps:

    1. Complete the Alberta Adult Health Benefit application as before.
    2. Attach a copy of your 2024 CRA Notice of Assessment.
    3. Email, mail or fax it.

Exception committee

The Health Benefits Exception Committee reviews requests for drugs, optical, dental, ambulance services or diabetes supplies that are not covered in the optical agreements, dental agreements or drug benefit lists. To submit a request for an exception, complete the Request for a Health Benefit Exception form and follow the instructions contained in the form.

If your request is for drugs or nutritional products that are not covered on the drug benefit lists, your doctor must provide a detailed medical rationale using the Request for Prescription Drugs and Nutritional Products form.

If your request is for optical services that are not covered in the optical agreements, please have your optical services provider (ophthalmologist, optometrist, or optician) complete the Request for Optical Services form.

Contact

Connect with the Health Benefits Contact Centre:

Phone: 780‑427‑6848
Toll free: 1‑877‑469‑5437
Email: [email protected]

Fax: 780‑415‑8386 (Edmonton area)
Toll free fax: 1‑855‑415‑8386

Mailing address:

Health Benefits Contact Centre
PO Box 2222 Station Main
Edmonton, Alberta  T5J 5H3

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