Alberta Adult Health Benefit (AAHB)

Published Date: July 01, 2015
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Exceptions to Qualifying Income Levels for Renewal

A client’s current income may be significantly lower than reported on their last year’s income tax return. When a client’s income reported on the AAHB Tax Information Report combined with the reported income from spouse/partner if applicable, is higher than the AAHB qualifying income levels, the worker may request documentation to verify:

  • Anticipated income for the current income tax year, and
  • Ongoing health needs (only those drugs and diabetic supplies required on an ongoing basis and covered by the HBC).

Based on this documentation, the worker may determine a household unit is eligible for AAHB based on the following:

  • Current verified combined net income from all sources of the adult household members,

     

  • Minus verified on-going eligible health needs of the household members,

     

  • Is equal to or less than applicable qualifying income level.

Example 1
Household unit (2 adults and 3 children) had $45,000 net combined household income in the last taxation year verified by their CRA Notice of Assessment. The applicable qualifying income level is $41,594. Due to reduced work hours, their anticipated combined net income for the current income tax year is $3,550 monthly. One child has a monthly need for asthma medication costing $80, and an adult has a monthly need for diabetic supplies costing $95. They have no health coverage through employment or other sources.

Total projected income for the year ($3,550 x 12)   $42,600
minus health costs ($80 + $95 x 12) $2,100 = $40,500

Qualifying income level for this household unit is $41,594 or less, therefore, they are eligible for AAHB.

Example 2
Household unit (single individual) had $20,500 net income in the last taxation year verified by his CRA Notice of Assessment. The applicable qualifying income level is $16,580. He anticipates his net income for the current income tax year will be the same. He has a monthly need for heart medication costing $365. He has no health coverage through employment or other sources.

Total projected income for the year $20,500
minus health costs ($350 x 12) $4,200 = $16,300

Qualifying income level for this household type is $16,580; therefore, he is eligible for AAHB.

Example 3
Household unit (couple with no children) had $28,000 net household income in the last taxation year verified by their CRA Notice of Assessment. One adult was previously an AISH recipient. The other is employed, but was laid off work for 6 weeks so his income is less than last year. The applicable qualifying income level is $23,212. Their anticipated combined net income for the current income tax year is $2,050 monthly. One adult has a monthly need for antidepressant medication costing $112. The other adult says he needs dental work, but has no ongoing health needs for prescription drugs or diabetic supplies. They have no health coverage through employment or other sources.

Total projected income for the year ($539 x 46) $24,794
minus health costs ($112 x 12) $1,344 = $23,450

Qualifying income level for this household unit is $23,212 or less, therefore, they are not eligible for AAHB. They should be informed of the process for appeal through Community and Social Services. 

Substantiation for Exceptions to Qualifying Income Level
Clients verify their income for the current income tax year by providing pay stubs, bank records, letter from employer or other income source, etc. Documentation must be sufficient to establish the anticipated income for the rest of the year.

Clients verify their health needs by providing pharmacy printouts and letter(s) from their doctor or other prescriber. Only the costs of drugs (including over-the-counter drugs and specialized nutritional products) and diabetic supplies required by the client on an ongoing basis (every month or every two months) that are covered by the HBC or approved by the Health Benefits Exception Committee may be used to establish an estimated cost of the household unit’s health needs.

Clients verbally declare if they have employer health benefits or health benefits through private insurance. If they have such coverage they must provide details of what coverage is available through their other plan.

Household units not financially eligible for the AAHB based on the qualifying income levels or by exception may appeal the decision to an appeal panel.