Alberta Child Health Benefit

Important notice

Overview

The Alberta Child Health Benefit covers health benefits for children in low-income households. This health plan is for children up to 18 years of age. Children who are 18 or 19 years old also qualify, if they are living at home and attending high school.

This program provides coverage for:

• dental care
• prescription drugs
• eye 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 Child Health Benefit plan may cover your remaining costs. Talk to your dental provider, optical provider or pharmacist about how this works.

What is covered

• Dental care
  • basic and preventative services like fillings, x-rays, examinations and teeth cleaning
• Optical benefits
  • Eye glasses every year
• Prescription drugs
  • The list of eligible prescription drugs found here:
    • Interactive Drug Benefit List
    • Some over-the-counter products, such as children’s vitamins
• 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 under 18 years old who are living with diabetes. A prescription from an endocrinologist or pediatrician is required. Learn more about the eligibility criteria.

Talk to your doctor, dental provider, optical provider or pharmacist to learn which items are paid for by this health benefit plan.

Eligible applicants

Families qualify based on income.

To be eligible for the Alberta Child 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 Albertans with First Nations or Inuit status (Non-Insured Health benefits program)

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

*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

Step 1. Fill out the application form

Alberta Child Health Benefit application form AEHB2939

• Sign and date the sections marked My Declaration and Consent for Canada Revenue Agency.

Step 2. Mail or fax your application form

Contact us

After you apply

Alberta Child Health Benefit Card

If your application is approved, you will receive a health benefits card in the mail. The card will list each child’s name and identification number.

You need to show this card to your child’s doctor, dental provider, pharmacist, optician or ambulance attendant each time your child receives a service that can be paid for by the Alberta Child 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 Child Health Benefit – 18 or 19 years old

In order for Alberta Child Health Benefit coverage to remain active for 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/cohabitating partner or child’s personal information, you must inform the Alberta Child 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 Child 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 DS5536

Reassess application denial

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 and received a rejection letter.

If you are applying for a reassessment between October 1, 2023, and February 28, 2024

If your Alberta Child Health Benefit application was rejected between October 1, 2023, and February 28, 2024, you can apply for an income reassessment based on your estimated 2023 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, 2023 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, 2023. This may include:
   • the remaining weeks of Employment Insurance you are eligible to receive
   • a current pay stub
   • a copy of 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 AEHB4008.
2. Write a cover letter explaining your current income situation and why it differs from your 2022 income.
3. Collect appropriate income verification/estimated income documents as stated above.
4. Mail or fax all reassessment documents:

If you are applying for a reassessment between March 1, 2024, and September 30, 2024

If your Alberta Child Health Benefit application was denied between March 1, 2024, and September 30, 2024, you can re-apply using your 2023 income as submitted to the Canada Revenue Agency. If your 2023 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 Child Health Benefit application as before.
2. Attach a copy of your 2023 CRA Notice of Assessment.
3. 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 AEHB3487 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 AEHB3810.

If your request is for optical services that are not covered in the optical agreements, have your optical services provider (ophthalmologist, optometrist, or optician) complete the Request for Optical Services form AEHB4001.

Contact

Connect with the Health Benefits Contact Centre:

Phone: 780‑427‑6848
Toll free: 1‑877‑469‑5437

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

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