Other Medical Services & Supplies

You and your dependants each have a maximum of $1,000 per tooth for dental treatment due to accidental injury (both inside and outside of Canada).

Note that accidental dental claims do not affect your annual or lifetime dental coverage limits. If you receive dental treatment due to accidental injury, please have your dentist complete the “Dental Accident” section of the Dental Care Claim. If the form you’re using does not have a specific section for accidental dental information, please mark the claim “Dental Accident” to prevent expenses from being applied to your annual dental maximum. Please ensure your dentist identifies all injured teeth on the form along with the date and details of the accident.

If services exceed the $1,000 per tooth maximum and you’re inside of Canada, your claim can be submitted under your Dental Care benefits and will be applied to your annual or lifetime dental claim maximums. If services exceed the $1,000 per tooth maximum and you’re outside of Canada, your claim may be covered under your Travel Emergency benefits.

Requirement(s): 

• Must be necessary for the treatment of either accidental dental injury due to an external blow to the mouth or damage caused from biting on a foreign object inserted in the mouth
• Treatment must be completed within two years of the accidental injury date
• Damage must not have existed prior to the accidental injury

Every calendar year (January to December), you and your dependants can each use up to $700 for acupuncture services. For MyRetiree Plans, every calendar year (January to December), you and your dependants can each use up to either $500 (Enhanced Plan) or $300 (Core Plan) for acupuncture services. Acupuncture treatments will be covered up to $65 a day per person.
You can easily track your expenses and view your usage summary on My ASEBP or the My ASEBP Mobile App.

Requirement(s): 

• Must be provided by an acupuncturist registered in the province of practice

Exclusion(s):

• No more than one treatment per day (per person)

You and your dependants each have 100 per cent coverage for professional ambulance services (ground and air)—regardless of whether or not you’re transported after treatment—at the rates negotiated between ASEBP and Alberta Health Services (AHS). Note that claiming practices may affect the time in which your claim is processed.

Requirement(s): 

• Must be used for the emergency treatment and/or transport of a patient to the nearest hospital that can provide adequate medical treatment and when no other means of transportation is appropriate
• Ambulance services provided in a province other than Alberta are covered to the price negotiated within that province
• If you receive an invoice from the provider, call EMS Accounts Receivable at 1-877-506-3230 as you shouldn’t pay the provider directly because ASEBP has a direct billing agreement with ambulances

Exclusion(s):

• Trips that are:
  • not an emergency
  • to a treatment facility that is not active
  • between active treatment facilities (the sending hospital is responsible for this fee)
  • to or from a nursing home
  • pre-arranged or pre-booked
• Additional fees (e.g. late payment charges, surcharges, escort charges, medications or other charges such as the Jaws of Life, etc.)
• Fire department response fees

Every calendar year (January to December), you and your dependants each have a maximum of $40 towards the purchase of an aerochamber. Inhalers are covered separately.

Exclusion(s):

• Repairs

Every calendar year (January to December), you and your dependants each have a maximum of $40 towards the purchase of allergy testing materials.

Based on a rolling three-year period, you and your dependants each have a maximum of $150 towards the purchase of a digital blood pressure monitor.

Exclusion(s): 

• Repairs

Based on a rolling two-year period, you and your dependants each can be reimbursed for a maximum of one brace per body part (e.g. left ankle, right ankle, left wrist, right wrist, back), to a maximum of $500 per brace. A brace is a device or appliance used to support limbs or other body parts.

Requirement(s): 

• If applicable, your receipt must state the side (left or right) of the body that the brace is intended for

Exclusion(s):

• Splints, which keep an injured body part immobile for healing purposes and are often temporary

Every calendar year (January to December), you and your dependants each have a combined maximum of $100 towards the purchase and/or rental of canes, casts, cervical collars, crutches and walkers. Canes, casts, cervical collars, crutches and walkers are covered up to $40 per one item for each category. 

Exclusion(s):

• Repairs
• Splints

Every calendar year (January to December), you and your dependants can each use up to $700 for chiropractic services. For MyRetiree Plans, every calendar year (January to December), you and your dependants can each use up to either $500 (Enhanced Plan) or $300 (Core Plan) for chiropractic services. Chiropractic treatments, including X-rays related to treatment and telephone and video call, will be covered up to $50 a day per person. You can easily track your expenses and view your usage summary on My ASEBP or the My ASEBP Mobile App.

Requirement(s): 

• Must be provided by a chiropractor registered in the province of practice

Exclusion(s):

• No more than one treatment per day (per person)

Every calendar year (January to December), you and your dependants each have a combined maximum of $250 towards the purchase of medically necessary compression garments (gloves, sleeves, support hosiery and surgical stockings).

Requirement(s): 

• Support hosiery, gloves, sleeves and surgical stockings require a minimum gradient of 20-30mmHg
• Receipts must include pressure gradient
• Only gloves, sleeves, support hosiery and surgical stockings are covered

Every calendar year (January to December), you and your dependants each have a maximum of $4,000 towards the purchase of alcohol swabs, glucose monitors, lancets, penlets and syringes. Additionally, if you or your dependants have insulin-dependent diabetes, you can use your maximum to purchase a flash glucose monitor (e.g. FreeStyle Libre) based on a rolling two-year period and 30 sensors based on a rolling one-year period. Insulin pumps, continuous glucose monitoring receivers/transmitters and insulin are covered separately.

Exclusion(s):

• Batteries
• Glucose control solution

Every calendar year (January to December), you and your dependants each have a combined maximum of $600 towards the purchase of dressings, bandages and related supplies.

Requirement(s):

• Must be necessary as a result of a chronic medical condition
• Must be pre-approved by ASEBP prior to purchase (please contact us for pre-approval requirements)

You and your dependants each have a lifetime maximum of $4,000 to treat varicose veins by endovenous laser, radiofrequency endovenous ablation therapy or with medical adhesives (e.g. VenaSeal).

Requirement(s): 

• Must be provided by a doctor or other licensed health care provider

Exclusion(s): 

• Ultrasound-guided sclerotherapy treatment

Every calendar year (January to December), you and your dependants each have a maximum of $200 ($100 for MyRetiree Core Plans) towards the purchase of foot orthotics and/or arch supports.

Requirement(s): 

• Orthotics and arch supports must be custom made and individually fitted

Exclusion(s):

• Repairs
• Heel lifts
• Off-the-shelf products (e.g. Birkenstock, Blundstone, etc.)

Based on a rolling three-year period, you and your dependants each have a maximum of $600 towards the purchase of hairpieces or wigs.

Requirement(s):

• Only for hair loss due to radiation, chemotherapy or other serious medical conditions
• Must be pre-approved by ASEBP prior to purchase (please contact us for pre-approval requirements)

Based on a rolling three-year period, you and your dependants each have a maximum of $3,000 ($1,500 for MyRetiree Core Plan) towards the following hearing-related supplies and services:

• Hearing tests (maximum of $70 on a rolling three-year period)
• Purchase, repair and/or replacement (not accident-related) of hearing aids and related supplies.
  • Damages caused by an accident: You and your dependants each have a lifetime maximum of $3,000 ($1,500 for MyRetiree Core Plan) for expenses resulting from accident-related damages
• Batteries for cochlear implants

Exclusion(s):

• Batteries for hearing aids
• Cochlear implant devices

You and your dependants each have a lifetime maximum of 4,000 hours for home nursing care (e.g., private-duty professional nursing services provided in the home) within Canada. For MyRetiree Enhanced and Core Plans, every calendar year (January to December), you and your dependants each have a maximum of $10,000 (part of a lifetime maximum of $25,000) for home nursing care within Canada.

Registered nurses and graduate nurses will be covered up to $42 per hour; registered licensed practical nurses will be covered up to $27 per hour.

Requirement(s):

• Must be provided by a registered nurse, graduate nurse or registered licensed practical nurse 
• Must be deemed as an appropriate service or course of treatment by your doctor or other licensed health care provider (e.g. occupational therapist)
• Must be pre-approved by ASEBP prior to service (please contact us for pre-approval requirements)

Exclusion(s): 

• Homemaker, homecare services and custodial care (e.g. assistance for bathing, house cleaning, meal prep, etc.)

You and your dependants each have a lifetime maximum of $3,000 towards the purchase or rental of a hospital bed. Hospital beds allow for variable angles of incline and easily raised or lowered to assist the patient and caregivers. Hospital beds are meant for single occupancy, and allow for additional options such as IV hooks, safety rails and overbed tables.

Requirement(s):

• Must be necessary as a result of a chronic medical condition
• Must be pre-approved by ASEBP prior to purchase (please contact us for pre-approval requirements)

Exclusion(s):

• Beds (including adjustable beds) that do not qualify as “hospital beds”

You and your dependants are each covered 100 per cent (70 per cent for MyRetiree Core Plans) up to the Government of Alberta’s daily rate for a semi-private hospital room within Canada. 

Requirement(s):

• Service must be from an institution regarded as an accredited hospital. To be recognized as a hospital, the institution must:
  • be accredited as a hospital by the Canadian Council on Hospital Accreditation,
  • be approved for resident in-patient care under a provincial hospital services program,
  • be primarily engaged in the in-patient medical care and treatment of sick and injured persons,
  • provide medical, diagnostic and major surgical facilities, and
  • provide 24-hour-a-day nursing service.

Exclusion(s):

• Services from an institution not regarded as an accredited hospital, including:
  • an institution which is primarily a home for the aged, rest home or nursing home,
  • a facility solely dedicated to addiction treatment,
  • a facility that operates under the Mental Health Act, and
  • an institution operating primarily as a school or furnishing custodial care (e.g. auxiliary hospital, palliative care or respite room).

Every calendar year (from January to December), you and your dependants each have a maximum of $1,000 towards the purchase of ileostomy, colostomy and urinary incontinence supplies.

Requirement(s): 

• The expense must qualify for Alberta Aids to Daily Living (AADL) coverage

Exclusion(s):

• Tubing
• Skin care products

Based on a rolling four-year period, you and your dependants each have a combined maximum of $5,000 towards the purchase of insulin pumps and continuous glucose monitoring receivers/transmitters. Other diabetic supplies and insulin are covered separately.

Exclusion(s):

• Batteries
• Glucose control solution

Every calendar year (January to December), you and your dependants each have a maximum of $150 towards the purchase of intravenous supplies (e.g. hep-locks, IV solutions, IV tubing, needles and swabs).

For joint injectable material details, please see Drugs.

Every calendar year (January to December), you and your dependants can each use up to $700 for massage therapy services. For MyRetiree Plans, every calendar year (January to December), you and your dependants can each use up to either $500 (Enhanced Plan) or $300 (Core Plan) for massage therapy services. Massage therapy treatments will be covered up to $75 a day per person.

You can easily track your expenses and view your usage summary on My ASEBP or the My ASEBP Mobile App.

Requirement(s):

• Must be provided by a massage therapist registered in the province of practice (all of Canada) and have a minimum of 2,200 hours of training or equivalent competency (Alberta only)

Exclusion(s):

• No more than one treatment per day (per person)
• Services provided by massage therapy students—even if they’re registered with a professional college or association

Every calendar year (January to December), you and your dependants each have a maximum of $200 for naturopathy services including telephone and video call sessions. Naturopathy treatments will be covered up to $20 a day per person.

Requirement(s):

• Must be provided by a naturopathic practitioner registered in the province of practice or a member of the Canadian Naturopathic Association (for those provinces where there is no licensing body)

Exclusion(s):

• No more than one treatment per day (per person)
• Naturopathic medicines

Based on a rolling two-year period, you and your dependants each have a maximum of $1,500 ($750 for MyRetiree Core Plans) towards the purchase of orthopedic shoes.

Requirement(s):

• Must be necessary because of an anatomical deformity, and a physician's letter/prescription stating the anatomical deformity is required with claim submission
• Shoes must be custom made and individually fitted—if a brace is attached to the shoe, the brace must extend partway up the leg

Exclusion(s): 

• Repairs
• Off-the-shelf products (e.g. Birkenstock, Blundstone, etc.)

Coverage for out-of-province specialized treatment expenses for you and your eligible dependants are only considered if not available in your province of residence.

Requirement(s):

• Specialized treatment you seek is available within Canada but outside your province of residence
• The Alberta Health Care Insurance Plan acknowledges the treatment and accepts the expense for reimbursement
• Must be pre-approved by ASEBP prior to treatment (please contact us for pre-approval requirements)
• Must be for an expense eligible under your ASEBP benefits (e.g.: a hospital stay, or medication received while out of province)

Exclusions:

• Outside of Canada treatment
• Out-of-province purchase of products and services that are not eligible under your ASEBP benefits

Every calendar year (January to December), you and your dependants each have a maximum of $1,000 towards the purchase, repair, rental and/or shipment of oxygen and supplies required for its use.

You and your dependants each have a lifetime maximum of $300 towards the purchase of one phototherapy light.

Requirement(s): 

• Must be required to treat seasonal affective disorder, and a physician's letter/prescription stating the diagnosis must be included with the claim submission

Exclusion(s):

• Batteries
• Repairs
• Replacement bulbs

You and your dependants each have a lifetime maximum of $300 towards the purchase or rental of medically necessary physical rehabilitation equipment.

Note: for TENS machines and neuromuscular stimulators, you and your dependants each have a $150 maximum every three years up to a lifetime maximum of $300.

Requirement(s): 

• A physician's letter/prescription stating the diagnosis must be included with the claim submission. Please note that letters/prescriptions from physiotherapists and chiropractors do not qualify.

Exclusion(s): 

• Repairs
• Handheld massage guns or percussion massage devices

Every calendar year (January to December), you and your dependants can each use up to $700 for physiotherapy services. For MyRetiree Plans, every calendar year (January to December), you and your dependants can each use up to either $500 (Enhanced Plan) or $300 (Core Plan) for physiotherapy services. Physiotherapy treatments, including telephone and video call sessions, will be covered up to $75 a day per person.

You can easily track your expenses and view your usage summary on My ASEBP or on the My ASEBP Mobile App.

Requirement(s): 

• Must be provided by a physiotherapist registered in the province of practice

Exclusion(s):

• No more than one treatment per day (per person)

Every calendar year (January to December), you and your dependants each have a maximum of $700 for podiatric services. For MyRetiree Plans, every calendar year (January to December), you and your dependants can each use up to either $500 (Enhanced Plan) or $300 (Core Plan) for podiatric services. Podiatry treatments, including X-rays related to treatment, will be covered up to $50 a day per person.

Requirement(s):

• Must be provided by a podiatrist

Exclusion(s):

• No more than one treatment per day (per person)
• Facility fees

Breast Prostheses

Every calendar year (January to December), you and your dependants each have a maximum of $400 per breast towards the purchase of breast prostheses.

Exclusion(s):

• Repairs
• Bras

Eye Prostheses

Based on a rolling three-year period, you and your dependants each have a maximum of $500 towards the purchase and/or repair of an eye prostheses.

Larynx Prostheses

Based on a rolling three-year period, you and your dependants each have a maximum of $2,000 towards the purchase and/or repair of a larynx prostheses.

Limb Prostheses

Based on a rolling three-year period, you and your dependants each have a combined maximum of $15,000 per limb towards the purchase, repair and/or replacement of prosthetic limbs, myoelectric limbs and stockings.

Exclusion(s): 

• Adults are restricted to no more than one replacement per limb on a rolling three-year period. Dependants under the age of 18 are still subject to the $15,000 per limb maximum, but are covered for more than one prosthesis per limb.

Every calendar year (January to December), you and your dependants each have a maximum of $1,200 for psychology services. For MyRetiree Plans, every calendar year (January to December), you and your dependants can each use up to either $1,000 (Enhanced Plan) or $600 (Core Plan) for psychology services. Psychology sessions, including telephone and video call sessions, will be covered up to $180 for the first hour and a maximum of $90 for each additional half hour.

Psychology services are intended to support positive mental health and well-being, and for the treatment  of mental, nervous or emotional conditions, such as stress, anxiety or trauma.

For sessions less than one hour, the coverage will be prorated based on the length of the session. Group/family counselling is covered and prorated based on both the length of the session and the number of patients attending.

Requirement(s):

• Must be provided by a chartered psychologist, a provisional psychologist who is under the supervision of a chartered psychologist or a person holding a Master of Social Work degree
• Provider must be registered in the province of practice 
• Receipts for claim submissions must include:
  • the provider's name, address and credentials (note: in cases of provisional psychologists, the name of the supervising psychologist must also be included),
  • the length of each session,
  • the amount being charged for each session, and
  • each patient's name if more than one person is attending a session.

Exclusion(s):

• No more than one session per day (per person)
• Services provided by counsellors
• Subscription-based online psychology/counselling services

Based on a rolling five-year period, you and your dependants each have a combined maximum of $1,500 (per person) toward the purchase or rental of respiratory equipment (e.g. continuous positive airway pressure (CPAP) machines, sleep apnea dental appliances, nebulizers, peak flow meters, air purifiers, etc.).

You can easily track your expenses and view your usage summary on My ASEBP or the My ASEBP Mobile App.

Requirement(s): 

• For equipment used to treat sleep apnea (e.g. CPAP machines or sleep dental appliances), a sleep study indicating the following is required:
  • Anyone 18 and older must have an apnea-hypopnea index (AHI) of 15 or greater
  • Dependants under 18 must have an AHI of 1 or greater
• Sleep apnea dental appliances must be purchased—not repaired or rented
• Air purifiers must be required for a chronic lung condition (e.g. asthma, COPD) and intended for household use
  • A physician's letter/prescription stating the diagnosis must be included with the claim submission
  • Air purifier appliances must have high-efficiency particulate air (HEPA) filter

Exclusion(s):

• Batteries
• Chargers or charging cords
• Sleep studies, testing and dental examination fees
• Cleaning supplies
• Replacement filters

Every calendar year (January to December), you and your dependants each have a maximum of $200 (per person) toward the purchase or rental of respiratory equipment accessories (e.g. tubes, masks, etc.) and repairs. A sleep study isn't required to access this coverage.

Exclusion(s):

• Batteries
• Chargers or charging cords
• Cleaning supplies

For sclerotherapy details, please see Drugs. It’s important to note that ultrasound-guided sclerotherapy treatment is not covered.

You and your dependants each have a lifetime maximum of $300 towards the purchase of one ultraviolet light.

Requirement(s): 

• Must be required to treat psoriasis, and a physician's letter/prescription stating the diagnosis must be included with the claim submission

Exclusion(s):

• Batteries
• Repairs
• Replacement bulbs

Based on a rolling four-year period, you and your dependants each have a combined maximum of $4,000 toward the purchase, repair, replacement and/or rental of wheelchairs or scooters.

Requirement(s):

• Must be pre-approved by ASEBP prior to purchase (please contact us for pre-approval requirements)

Exclusion(s):

• Knee scooters/walkers