What is covered

Know what is covered. Before choosing to have elective (non-emergency) surgery outside Canada, contact the Alberta Health Care Insurance Plan (AHCIP) Out-of-Country unit at 780-422-1954.

Limited coverage

The AHCIP covers only limited physician and hospital costs outside of Canada.

If you get medical or hospital care when outside of Canada, you will be responsible for paying the difference between the amount charged and the amount the AHCIP reimburses you.

If you claim coverage under the AHCIP, it is your responsibility to pay the health service provider. Submit a claim to the AHCIP office to request reimbursement for eligible out-of-country health expenses. Reimbursement is issued in Canadian funds only.

Emergency medical care and transportation can be expensive. You should have additional travel medical insurance when you travel outside Alberta.

Physician services outside Canada

If you get insured services from a physician outside Canada you will be reimbursed either the amount you claimed for the physician’s services, or the rate an Alberta physician is paid for that service, whichever amount is less.

Services and rates paid to Alberta physicians are listed in the Schedule of Medical Benefits.

Hospital services outside Canada

Hospital services must be services that would normally be covered by the AHCIP and must be provided in a general or auxiliary hospital. Payment for hospital services provided in a private health facility will not be reimbursed.

A hospital is defined as a place that provides diagnostic services and facilities for medical and surgical treatment for urgent medical conditions and short-term treatment for a severe injury or episode of illness.

Hospital-services rates are the maximum that is reimbursed for all services provided to a patient, such as room and board, nursing, laboratory and X-ray services, medical supplies, and prescription drugs.

The rate for in-patient hospital services is $100 (Canadian) per day, not including the day of discharge. The rate for outpatient services is $50 (Canadian) per day, with a limit of one visit per day.

Out-of-country health services funding

The Out-of-Country Health Services Committee considers applications for funding of insured medical, oral surgical and/or hospital services that are not available in Canada.

Learn about out-of-country health services, the application process and how to appeal a decision.

What is not covered

Services and expenses that the AHCIP does not cover include (but are not limited to):

  • food, lodging, transportation, or other costs related to obtaining health services outside Alberta
  • health services provided by health care providers other than physicians including:
    • chiropractor
    • acupuncturist
    • massage therapist
    • homeopath
    • nutritionist
    • psychologist
    • podiatrist
    • optometrist
    • physician assistant
    • nurse practitioner
  • air or ground ambulance services
  • mental health services not provided in a general hospital
  • publicly funded services (services in Alberta funded by Alberta Health Services) such as:
    • home care
    • behavioral disorders
    • addiction treatment
  • prescription medication
  • medical/surgical appliances, prosthetics
  • experimental or research procedures, for example, clinical trials

Submit a claim

Learn how to submit a claim for insured health services.

Contact

Connect with the Alberta Health Care Insurance Plan office.