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Coordination of Benefits for Members Aged 65 and Over

Some people are not aware that the Government of Alberta provides premium-free health care benefits for some services not covered under the Alberta Health Care Insurance Plan to anyone age 65 years and older under a plan called Coverage for Seniors.

Registering for Coverage for Seniors Means:

  • You maximize the value of your Alberta Health Care coverage without paying additional benefit premiums
  • You maximize your ASEBP coverage by coordinating benefit plans (sharing the cost between plans) to reduce your health related out-of-pocket expenses — in some cases to zero!
  • You help minimize any increases to your ASEBP yearly premiums

How Does it Work?

You or your dependent — including spouse (whomever is turning 65) should receive an enrollment package from the Government of Alberta for Coverage for Seniors. Every Albertan, aged 65 and over, qualifies to have benefits under Coverage for Seniors. All that you, or your dependent, need to do is complete and return the application sent to you by the Province.

Once you or your dependent turn 65, Coverage for Seniors becomes first payer for you and your spouse's claims. If you have ASEBP coverage, you can it to further reimburse yourself for out-of-pocket expenses (up to the maximums allowed by your ASEBP plan).

For example, that means that you will present your new Coverage for Seniors ID card at the pharmacy for your prescription drugs, along with your ASEBP ID card. Your benefits will be coordinated and eligible claim amounts paid automatically.

Claims for prescription drugs, ambulance services, clinical psychological services, home nursing care, certain prosthetic and orthotic benefits, and mastectomy prostheses must be submitted through Coverage for Seniors before being considered by ASEBP for reimbursement of any remaining balance. This applies whether the claim is for yourself or your dependent.

Please note: As of April 1, 2004, if you or your dependent are eligible for the above benefits through Coverage for Seniors (i.e. one of you is age 65 or older), ASEBP will not be able to consider a claim unless it has first been submitted to Coverage for Seniors. Once that program has paid its portion, any unpaid balance can be submitted following coordination of benefits guidelines. Any claims that come to ASEBP first will be returned to you for submission to Coverage for Seniors.

How Do I Find Out More?

For more information about Coverage for Seniors, contact Alberta Health & Wellness at:

For more information about your ASEBP benefits, contact a Benefit Specialist:

  • Toll-free within Alberta: 1-877-431-4786
  • Edmonton local & outside Alberta (780)-431-4786
  • Email: benefits@asebp.ab.ca