Table of contents

COVID-19 response

AHCIP forms

AHCIP forms may now be submitted by fax at 780-422-0102, as well as by mail or through a participating registry agent. Ensure copies of all documents being faxed are clear and readable.

Apply or update information

To apply for the Alberta Health Care Insurance Plan (AHCIP) or make changes to your information:

  • download and complete the appropriate form
  • send the completed form to the AHCIP office, or bring it to a participating registry agent office

You can also get forms from a participating registry agent or contact us to get a form.

Apply for health care coverage

PDF form issues

Fillable PDF forms do not open properly on some mobile devices and web browsers. To fill in and save the form:

  1. Save the PDF form to your computer – click or right-click the link and download the form.
  2. Open the PDF form with Adobe Reader. Fill it in and save it.

Update or make changes to your card information

Submit form

Do not send information or forms by email; email is not secure. Fill in, print and submit your application:

Group forms

Order a replacement card

Find out how to request a replacement card if you lost your card or it is damaged.

Alberta Blue Cross benefits

Alberta Blue Cross administers supplementary benefit plans on behalf of the Government of Alberta.

If you have questions about benefit forms, contact Alberta Blue Cross.

Find out how to claim for benefits through Alberta Blue Cross.

Statement of Benefits Paid

A Statement of Benefits Paid (SOBP) is a list of physician services paid for by the AHCIP on your behalf during a specific period. It includes the date and general type of service, physician name and the amount that was paid to the physician.

The requested SOBP is sent directly to the individual or their authorized representative.

Hospital services do not appear on the SOBP. These may be requested directly from the hospital.

How to order an SOBP

Current year

There is no cost for an SOBP for the most recent benefit year (July 1 to June 30) to the current year to date.

To request a current SOBP:

Download and complete the Request for Statement of Benefits Paid form (PDF, 156 KB) and mail the completed form to the AHCIP office.

Or, place an order using the automated phone system:

Previous years

An SOBP can be requested back to October 1, 1993. There is a fee of $25 plus GST ($26.25) per request for individuals ordering a personal SOBP directly.

Families ordering for more than one person on the same AHCIP account pay only $26.25 for everyone.

To request an SOBP from previous years:

  1. Download and compete the Request for Statement of Benefits Paid form (PDF, 156 KB).
  2. Mail the completed form with your payment. Only cheques or money orders are accepted, payable to “Government of Alberta.”

Third-party requests

If a third-party such as law firm or insurance company wishes to request an SOBP on behalf of an Albertan, contact Alberta Health  by emailing [email protected].

Effective January 1, 2020, the fee for third-party SOBP requests is $75 ($78.75 with GST).

SOBP help

Contact us if you need help, or are from a law firm or insurance company requiring this statement.

Office hours: 8:15 am to 4:30 pm, Monday to Friday, excluding holidays
Email: [email protected]

Contact

Connect with the Alberta Health Care Insurance Plan office.

Related

When to cancel health care coverage

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