General Policy

Published Date: August 01, 2011
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General Policy

IESA Section 7 and IESA Section 8 establishes the authority to provide health benefits.

ISTHB Regulation, Section 73 establishes the types and lists of health benefits provided.

ISTHB Regulation, Section 74 establishes the authority of the Health Benefits Exception Committee to approve health benefits not listed in the agreements and drug lists referred to in Section 73.

INTENT

To ensure eligible persons have access to goods and services essential to health and well-being, including prescription and non-prescription drugs and nutritional products; optical, dental, and ambulance services; and essential diabetic supplies.

POLICY

Health benefits are goods and services, provided within the rules specified in the applicable agreements and drug lists per ISTHB Regulation, Section 73.

Other goods/services, which may be health related, such as medical/surgical suppliesspecial diets and CPAP machines may be provided as a Supplementary Health Benefit to persons eligible for Income Support (IS), including Learners.

The dental, denturist and optical agreements can be accessed on the ministry intranet.

The Alberta Health Drug Benefit List and Drug Benefit Supplement have been combined in the online Interactive Drug Benefit List, and can be accessed on the Alberta Health website.

Health benefit coverage is not provided to a person outside of Alberta, and payment is only made to pharmacies, dental, optical and ambulance providers located in Alberta.

Clients are expected to use their health benefits card to obtain eligible health goods or services. Only in exceptional circumstances is a client reimbursed for the cost of a health benefit. Reimbursement is not made unless the good or service was prior approved, or the expense was incurred during an emergency situation.

Community and Social Services Health Benefit Programs
Under the authority of the IESA and ISTHB Regulation, Community and Social Services provides health benefits to eligible children and adults through the following programs:

  • The IS program for all eligible household members of ETW and BFE clients,
  • The IS program for all eligible Learners and their spouse/partner
  • The Alberta Child Health Benefit (ACHB) program for eligible dependants/children in Learner households, as well as low-income eligible household members not receiving IS or AISH
  • The Alberta Adult Health Benefit (AAHB) program for all eligible household members.