Out-of-country health services application process

Overview

The Out-of-Country Health Services Committee (Committee) reviews applications for payment of expenses for insured services and insured hospital services to be provided outside of Canada when those insured services are not available in Canada and when all other appropriate health service options in Canada have been fully exhausted.

The Committee is independent and operates at arm’s-length from the Ministry of Health and is required to follow the Out-of-Country Health Services Regulation.

Eligibility

The application and all clinical documentation must be submitted by a licensed Alberta physician or dentist who is registered in Alberta under the Health Professions Act.

Patients are not permitted to self-refer and may not submit the application or documentation.

The patient who has or will receive the out-of-country health services must be registered under the Alberta Health Care Insurance Plan.

How to apply

Step 1: Application

Download the Out-of-Country Health Services application form

The application must be completed and submitted by the applying Alberta physician or dentist, on behalf of the patient. The application must contain clinical documentation to support the request for out-of-country health services.

Note: financial documents, invoices, receipts, or any other information related to the payment for expenses of out-of-country services will not be accepted.

Step 2: Submission requirements

The request for out-of-country health services must meet the program requirements and prior approval is required.

All out-of-country health services received prior to the Committee's decision, will be the patient’s responsibility.

Waitlists in Canada or confirmed appointments for out-of-country health services are not in and of themselves valid reasons to approve an application.

Applications for out-of-country health services must meet all of the following requirements:

• insured under the Alberta Health Care Insurance Plan
• medically necessary
• not available in Canada and all appropriate Canadian health service options have been exhausted
• the standard of practice in Alberta for the patient’s medical condition
• not publicly funded, that is, occupational therapy, physiotherapy, mental health, addictions or behavioural services, residential mental health
• not part of a research study, clinical trial or experimental service

Step 3: Submit the application

The application submitted by an Alberta physician should contain:

• completed application form
• clinical documentation
• evidence the application meets the program requirements

Send the completed Committee application, including clinical documentation by mail or email.

The Committee Chair may request additional information and will inform the Alberta physician or dentist, in writing, of the application status, with a copy to the patient.

Note: submitting an application does not guarantee the approval of payment for expenses of health services.

Contact

Connect with the Office of the Out-of-Country Health Services Committee:

Email: [email protected]

Mail:
Chair, Out-of-Country Health Services Committee
PO Box 1360, Station Main
Edmonton, Alberta  T5J 2N3