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.
Eligible applicants
You may be eligible if you:
- are pregnant
- have high ongoing prescription drug needs
- are leaving the Income Support or Assured Income for the Severely Handicapped (AISH) programs due to excess income from employment, self-employment or CPP-D benefits
To be eligible for the Alberta Adult Health Benefit, you and members of your family must:
- live in Alberta
- be Canadian citizens or have permanent resident status in Canada
- meet the guidelines below
- not be receiving health benefits from other government programs:
- Income Support
- Assured Income for the Severely Handicapped (AISH)
- Child and Youth Support Program
- Canadian government programs for First Nations people and Inuit (Health Canada Non-Insured Health Benefits Program - NIHB)
- sponsored immigrants
- victims of human trafficking
- Alberta Seniors Benefit
- incarcerated individuals
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
| Family | Maximum 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.
- Look at Line 23600 to find out your basic income.
- Add any child support you receive, which is on Line 15600.
- 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.
- Download the Alberta Adult Health Benefit application form AEHB3931.
- Read and complete all sections of the form.
- Sign and date the section marked My Declaration – this means that you understand everything in your application
- 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.
- If applicable, include documentation that demonstrates your high ongoing prescription drug needs, such as a pharmacy dispensing history report.
- 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
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.
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.
Fillable PDF forms may not open properly on some mobile devices and web browsers. See the step-by-step guide or contact PDF form technical support.
Contact
Connect with the Health Benefits Contact Centre:
Phone: 780‑427‑6848
Toll free: 1‑877‑469‑5437
Email: ahb@gov.ab.ca
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