Benefit Plans

Question 1

Income Support
- What
- Premium and Copay
- Drugs Covered
- Who deals with Exceptions

Answer 1

• Barriers to full employment (School, Seeking work)
• No Premium, No Copay
• ADBL, AHSDBS
• No exceptions person

Question 2

Alberta Child Health Benefit
- What
- Premium and Copay
- Drugs Covered
- Who deals with Exceptions

Answer 2

• Under 18 years, low income family
• No Premium, No Copay
• Covers ADBL and AHSDBS drugs
• Exception Committee

Question 3

Alberta Adult Health Benefit
- What
- Premium and Copay
- Drugs Covered
- Exceptions

Answer 3

• Low Income + Pregnant / High Prescription Drug Needs
• No Premium, No Copay
• Covers ADBL and AHSDBS drugs
• Exception Committee

Question 4

Assured Income for the Severely Handicapped
- What
- Premium and Copay
- Drugs Covered
- Exceptions

Answer 4

• Older than 18, Younger than 65. Medical Conditions limit ability to work
• No Premium, No Copay
• Covers ADBL and AHSDBS drugs and Diabetic Supplies
• AISH Worker

Question 5

Palliative Care Health Benefits
- What
- Premium and Copay
- Drugs Covered
- Exceptions

Answer 5

• People with terminal conditions
• No Premium, No Copay
• Covers ADBL and Palliative Benefit Supplements

Question 6

Seniors Health Benefit
- What
- Premium and Copay
- Drugs Covered
- Exceptions

Answer 6

• Older than 65
• No Premium, 30% Copay (Max Patient Pays = $25)
• Covers ADBL, Diabetic Supplies ($2400/Year, No Copay)
• Covers Maintenance Therapy (100 Day Supply for Chronic Medications

Question 7

Non-Group Coverage
- What
- Premium and Copay
- Drugs Covered
- Exceptions

Answer 7

• Younger than 65
• Premium, 30% Copay (Max Patient Pays = $25)
• Government of Alberta covers (70% of MAC)
• Covers ADBL, Diabetic Supplies ($2400/Year, No Copay)
  
  • Continuous Glucose Monitor not counted towards $2400/Year, separate program
• Covers Maintenance Therapy (100 Day Supply for Chronic Medications

Question 8

Dispensing Policy (Normal)

Answer 8

90-100 Days
One Dispensing Fee

Question 9

Dispensing Policy (Adherence Package)

Answer 9

28-89 Days
One Dispensing Fee (Dispensed More Often)
Needs supporting Documentation

Question 10

Dispensing Policy (2-27 Days)

Answer 10

2-27 Days
Two Dispensing Fees per 28 Days

Question 11

Dispensing Policy (Daily)

Answer 11

1 Day
Three Dispensing Fees per Day

Question 12

Dispensing Policy (Acute)

Answer 12

4 Additional Dispensing Fees per 12 months

Question 13

Dispensing Policy (Opioid Therapy)

Answer 13

No Extra Fees