Alberta’s Non-Group Coverage is a supplementary health benefits program, administered by Alberta Blue Cross on behalf of the provincial government. It provides economical coverage for health services and products that are not included under the Alberta Health Care Insurance Plan (AHCIP). A monthly premium is charged for enrollment in Non-Group Coverage.
The program is available to all Alberta residents under the age of 65 and their eligible dependents who are registered with AHCIP. No medical review or questions about pre-existing conditions are required to obtain Non-Group Coverage, as all applicants are accepted regardless of their health status.
Frequently Asked Questions
- Why should you register for Alberta’s Non-Group Coverage?
- What is covered under Alberta’s Non-Group Coverage?
- Who is eligible for Alberta’s Non-Group Coverage?
- How to apply for Alberta’s Non-Group Coverage?
- What is the role of Alberta Blue Cross?
Why should you register for Alberta’s Non-Group Coverage?
There are several compelling reasons why Albertans under the age of 65 should consider enrolling in the Non-Group Coverage program.
The primary benefit of Non-Group Coverage is that it provides supplementary health benefits for services and products not covered under the standard Alberta Health Care Insurance Plan (AHCIP). This includes prescription drug coverage, ambulance services, clinical psychological services, home nursing care, prosthetics/orthotics, and coverage for private or semi-private hospital rooms. Without this additional coverage, Albertans would have to pay the full cost out-of-pocket for these expenses.
Another advantage is the affordability and accessibility of Non-Group Coverage. It is available to all Alberta residents under 65, regardless of their health status or pre-existing conditions, as no medical underwriting is required. The program charges a relatively low monthly premium, with subsidies available for lower-income Albertans through the Premium Subsidy Program. This makes supplementary coverage economically feasible for a wide range of the population.
For those without access to employer-sponsored group health insurance plans, such as self-employed individuals, students, or retirees, Non-Group Coverage provides a valuable option to obtain comprehensive supplementary coverage. It offers financial protection against unexpected medical costs and ensures access to essential healthcare services beyond what AHCIP covers alone.
What is covered under Alberta’s Non-Group Coverage?
Alberta’s Non-Group Coverage program provides supplementary health benefits for services and products that are not included under the standard Alberta Health Care Insurance Plan (AHCIP). It aims to make additional coverage more affordable and accessible for Alberta residents under age 65. The program is administered by Alberta Blue Cross on behalf of the provincial government, with monthly premiums charged for enrollment.
One of the key benefits covered is prescription drug coverage. Non-Group Coverage covers prescription medications listed on the Alberta Drug Benefit List, with participants paying a 30% co-pay up to a maximum of $25 per prescription filled. The plan also provides coverage for ambulance services when transporting a patient to or from a hospital due to illness or injury, up to the government-established rates. However, it does not cover inter-facility ambulance transfers.
For mental health support, Non-Group Coverage offers coverage for clinical psychological services provided by registered psychologists. Participants can claim up to $60 per visit, with an annual maximum of $300 per family. The plan also covers some home nursing care costs when ordered by a physician, up to $200 per family per benefit year.
Certain medical devices and supplies are also included under Non-Group Coverage benefits. The plan covers 25% of the maximum amount for listed prosthetic devices and braces required for 6 months or longer. It also pays 25% of the maximum for listed mastectomy prostheses. Additionally, Non-Group Coverage will cover the differential cost for patients who request a private or semi-private hospital room during their stay.
Services already provided under AHCIP, such as physician fees, are not covered by Non-Group Coverage. The plan also excludes hospital admission fees, non-listed drug products, medical equipment, vision care, dental services, and travel insurance for out-of-province or out-of-country medical expenses.
Who is eligible for Alberta’s Non-Group Coverage?
Single coverage is available to Alberta residents with no dependents.
Family coverage is available to Alberta residents along with their eligible dependents, which must be the same dependents covered under the subscriber’s AHCIP account. Eligible dependents include:
- Spouse
- Adult interdependent partner
- Unmarried children under 21 years of age who are fully dependent on the subscriber
- Unmarried children under 25 years of age who are in full-time attendance at an accredited educational institution
- Unmarried children 21 years of age or older who are fully dependent on the subscriber due to a mental or physical disability
It is important to note that government-sponsored supplementary plans like Non-Group Coverage cover pre-existing health conditions, and no medical review is required for enrollment.
Residents who have formally opted out of the AHCIP are not eligible for Non-Group Coverage during the opt-out period.
Albertans aged 65 and over are not eligible for Non-Group Coverage but may qualify for the Coverage for Seniors program instead.
How to apply for Alberta’s Non-Group Coverage?
To apply for Non-Group Coverage, Alberta residents under 65 years of age must complete the application form provided by Alberta Blue Cross. This form can be obtained by contacting the Alberta Health Care Insurance Plan (AHCIP) office.
Applicants must have active AHCIP coverage and cannot have any outstanding Alberta Blue Cross Non-Group Coverage premiums owing.
When submitting the application, applicants will need to provide information about themselves and any eligible dependents they wish to include on the coverage. Eligible dependents are the same as those covered under the subscriber’s AHCIP, such as a spouse, adult interdependent partner, or unmarried children under certain age limits.
Once the completed application is received by the AHCIP office, Non-Group Coverage will become effective on the first day of the fourth month following receipt of the application. However, if the application is submitted within 30 days of the applicant’s other supplementary health coverage ending, then Non-Group Coverage will begin on the first day of the following month.
It is important to note that no medical review or questions about pre-existing conditions are required, as all applicants are accepted into the government-sponsored Non-Group Coverage program regardless of their health status.
What is the role of Alberta Blue Cross?
Alberta Blue Cross is responsible for administering the Non-Group Coverage program on behalf of the Alberta government. While the government defines the program parameters like eligibility criteria, covered benefits, and premium rates, Alberta Blue Cross carries out the day-to-day operations and management of Non-Group Coverage.
One of Alberta Blue Cross’s primary roles is handling the enrollment process for Non-Group Coverage. They provide the application forms that Alberta residents must complete to enroll themselves and any eligible dependents in the program. Alberta Blue Cross then processes these applications and determines when coverage will become effective based on the established guidelines.
Another key function of Alberta Blue Cross is billing and collecting the monthly premiums from Non-Group Coverage enrollees. They are responsible for sending out premium invoices and ensuring payments are received on an ongoing basis to maintain an individual’s or family’s active coverage status under the program.
Additionally, Alberta Blue Cross processes and pays out all claims submitted for the supplementary health benefits covered under Non-Group Coverage. This includes claims for prescription drugs, ambulance services, clinical psychological services, home nursing care, prosthetics/orthotics, and hospital accommodation differentials. Alberta Blue Cross adjudicates these claims according to the benefit rules and maximums defined by the government.
Alberta Blue Cross also handles customer service inquiries related to Non-Group Coverage, such as questions about billing, claims, or general program information. They serve as the point of contact for enrollees requiring assistance with their supplementary coverage administered through this government-sponsored program.