AHCIP Alberta Coverage Summary

Alberta Health Care Insurance Plan (AHCIP)

Alberta’s provincial healthcare plan or the AHCIP coverage summary, which stands for Alberta Health Care Insurance Plan.

The following is a summary of AHCIP benefits and coverage.Affordable Health & Dental Plans

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All residents of Alberta must register themselves and their dependents with AHCIP in order to qualify for benefits.

Generally speaking, any service that is deemed medically necessary is covered by AHCIP.

Expenses/Services Covered by AHCIP

• Services deemed medically necessary by a qualified physician (applies to all services listed below).
• Standard hospital wards (semi-private and private rooms ONLY if medically required, which is rare).
• Medically necessary nursing services.
• One eye examination for seniors (aged 65 and up) and children aged 18 and under per year.
• Laboratory and diagnostic procedures.
• Medications that are administered in a hospital.
• Partial coverage for some oral, dental and maxillofacial surgeries.
• Ambulance transportation from one medical facility to another.
• Vasectomies (but not vasectomy reversal).
• Bariatric surgery for residents who qualify via the Alberta Weight Wise program.
• Psychiatrists (psychologists not covered).

Expenses Not Covered by AHCIP

• Cosmetic surgery unless deemed medically necessary. Examples are vasectomy reversals, abdominoplasty (tummy tuck) and breast reductions (mammoplasty).
• Prescription drugs obtained outside of a hospital or nursing home (however, there are specialty programs, see below for more information).
• Eye exams for residents aged 19-64 UNLESS deemed medically necessary as a result of some trauma.
• Routine dental treatment (e.g. cleanings, fillings and extractions).
• Ambulance transportation (except between medical facilities).
• Vision care such as glasses, laser eye surgery and contact lenses.
• Health services provided by people who are not physicians (e.g. massage therapists, chiropractors, acupuncturists, physiotherapists, naturopaths, nutritionists, psychologists, homeopaths and nurse practitioners). Note: services such as physiotherapy may be covered if performed in a hospital and deemed medically necessary.
• Hearing aids.
• Surgical and medical appliances, prosthetics, wheelchairs and other mobility devices. Note that basic medical equipment MAY be covered via the Alberta Aids to Daily Living program.
• Publicly funded services (e.g. funded by Alberta Health Services) performed OUTSIDE of Alberta. For example: midwivery, physiotherapy, cancer and homecare services, optometry and podiatry services, etc.
• Clinical psychologist services.
• Contact lenses and eye glasses.
• Semi-private and private hospital rooms UNLESS medically necessary.
• Medical advice obtained over the telephone.
• Dentures.

Services that are Partially Covered

The following are partially covered by AHCIP:

• Podiatry: some, although not all, podiatry services are covered up to a maximum of $250 per year. Contact the Alberta government for further details.
• Some dental, oral and maxillofacial surgical services if deemed medically necessary.
• Some dental benefits for seniors with low to moderate incomes (see the Dental and Optical Assistance for Seniors Program).
• Partial or full coverage for some optometry costs if treatment is required as a result of specific medical conditions. Contact the Alberta government for further details.

Prescription Drug Coverage Programs

The following lists specialty AHCIP prescription drug programs:

Outpatient Cancer Drug Benefit Program

Certain medications used to directly treat cancer are covered.

Specialized High Cost Drug Program

Some funding is available for drugs used in specialized procedures such as organ transplants and major heart surgery.

Retina Anti-Vascular Endothelial Growth Factor Program for Intraocular Disease

The RAPD program offers coverage for Avastin, Lucentis and Eylea, drugs which are used to slow down loss of vision.

Insulin Pump Therapy Program

designed for Albertans who have Type 1 or Type 3 diabetes. Covers the cost of an insulin pump and associated supplies.

– for full details go to the Alberta government’s health plan web site –

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Last updated March, 2019