Health Benefits Contact Us: Review Committee For more information on Alberta Works Health What does the Review Committee do? What happens next? Benefit Programs you can contact the following • This committee provides a fair review of • Your doctor may need to complete a offices or go to the websites listed below: health benefit decisions, and ensures that Request for Drugs and Nutritional Products Albertans with low income who have unique form if you need medication or over-the- Income Support Health Benefits medical needs can access the health supports counter products that are not covered on Contact your Income Support worker at the office they need. the Health Benefits Card. This form is also where your file is held. available from your worker or on our website • If you need a health benefit not covered on the Health Benefits Card, you can request employment.alberta.ca/hb-drugs. Attach Learner Health Benefits a review by the Health Benefits Review the completed form when you submit your Committee. request to your worker. Alberta Employment and Immigration Student Funding Contact Centre • The Health Benefits Review Committee will • The office handling your request will review PO Box 28000, STN Main review requests for drugs, optical, dental, all information you submit, answer your Edmonton, AB T5J 4R4 ambulance services and diabetic supplies that questions, and submit your documents along are not covered on your Health Benefits Card. with a Supervisory Summary to the Health Phone: Toll-free 1-800-222-6485 Benefits Review Committee. or 780-427-3722 in Edmonton • If one of the above benefits is not covered and you want to appeal the decision, refer to • Each case submitted to the Health Benefits Fax: Toll-free 310-0000, then enter 780-415-9947 Review Committee is reviewed and researched or 780-415-9947 in Edmonton the Contact Us section of the brochure for the office to contact. on an individual basis. • Staff working for the committee may contact Alberta Adult Health Benefit, and How do I request a review? your medical practitioners if more information Alberta Child Health Benefit • Obtain a Request for Review of Decision is needed. Alberta Employment and Immigration form from your worker or from our website • The committee makes decisions based on Health Benefits Contact Centre employment.alberta.ca/hb-review health benefits policy and the information PO Box 2222 • Complete the form explaining what decision you submit to support your request. Health Benefits Edmonton, AB T5J 5H3 you want reviewed, who will provide the • The committee’s written decision is mailed to Phone: Toll-free 1-877-469-5437 medical services you need, and the cost. you and includes the reasons for the decision. or 780-427-6848 in Edmonton • Attach any information related to your request Fax: Toll-free 310-0000, then enter 780-415-8386, that your health care provider can provide. Under Alberta Works, eligible individuals and or 780-415-8386 in Edmonton families with limited incomes can access free • Submit the completed form to the appropriate health benefits. Alberta Works Online Policies on Health Benefits office listed in the Contact Us section of this and the Health Benefits Review Committee brochure. This office can also provide additional Knowing your family’s health is cared for will employment.alberta.ca/hb-policy information and answer any questions you bring you peace of mind. may have. If you need assistance filling out General info on Alberta Works Health Benefits the form, please ask. For more detailed information please go to the employment.alberta.ca/hb Contact Us section on the back of this brochure. AEHB 1634 (2008/08) How do I know if I qualify for What does the How do I use the a Health Benefits Card? Health Benefits Card cover? Health Benefits Card? Income Support Prescription Drugs and Nutritional Products Whether you fill a prescription at a pharmacy, Maximum If you are receiving Income Support (including Family Type Income (effective • Many, but not all prescription drugs are paid have an eye exam, request eyeglasses or have Learners) you will receive a Health Benefits Card August 1, 2008) for. Some over-the-counter products, such as dental work done, you must always present your that provides health benefits coverage for you prenatal vitamins and children’s vitamins are Health Benefits Card. That way the medical office Single Individual $15,545 can tell you up front if the service you need is and your family. also covered. Your pharmacist has a list of Single Parent with 1 Child $24,397 what is free with the Health Benefits Card. covered by the card. Alberta Adult Health Benefit Single Parent with 2 Children $29,073 For example, if a prescription you need is You and your family may qualify for a Health Optical Care Single Parent with 3 Children $34,056 covered by the Health Benefits Card, the Benefits Card, under the Alberta Adult Health • Adults receive a free eye exam and eyeglasses pharmacist will provide it to you free of charge. Benefit program, if: Single Parent with 4 Children* $39,336 every 24 months if needed. The pharmacist then submits a claim to Alberta • You have high ongoing prescription drug needs, • Children receive free eyeglasses every 12 months Blue Cross, and they pay the pharmacist on Couple with no Children $21,763 and limited income. if needed (their annual eye exams are covered behalf of our department. Couple with 1 Child $29,285 by Alberta Health and Wellness). • You are pregnant and have limited income. The Drug Benefit Lists and the Agreements that • You leave Income Support (Expected to Work, Couple with 2 Children $34,346 Dental Care our department has with optometrists, opticians, Not Expected to Work) and you have income Couple with 3 Children $38,997 dentists and denturists will cover most of the • Basic services such as extractions and fillings from employment, self-employment, or the medical services that you and your family need. Couple with 4 Children* $44,000 are covered, in order to alleviate pain and Canada Pension Plan Disability program. infection. • You leave the Assured Income for the Severely * Add $4663.00 for each additional child Other Health Plans • In some cases additional services such as cleaning Handicapped (AISH) program and you have If your family gets services through another How do I figure out my income? and annual examinations are also covered. income from employment, self-employment, health plan, you must use that plan first. The You can calculate your income by looking at Ask your dentist about your coverage. or the Canada Pension Plan Disability program. Alberta Works Health Benefits Card can cover your last income tax return. your remaining costs. Talk to your doctor, dentist, • Look at Line 236 to find out your Ambulance Services Alberta Child Health Benefit optician or pharmacist about how this works. net income. • Emergency ambulance trips to the nearest Children in families with limited income can • Add any child support you receive, hospital are covered. IMPORTANT: Always present your Health receive coverage under the Alberta Child Health which is on Line 156. Benefits Card before you receive the service. Benefit program. Families qualify based on income. • Subtract the amount you were taxed, Diabetic Supplies If the service is covered by the card then it is which is on Line 128. provided free of charge. If the service is not The following chart provides income thresholds • Diabetic supplies such as injection supplies, The amount left is your income. If you have covered then you should ask the health care for the Alberta Adult Health Benefit and the testing strips, lancets and penlets are covered. trouble calculating your income, call us. provider or your worker about alternatives. Alberta Child Health Benefit programs. On the other side of this brochure, you will find information about the Health Benefits Review Committee. This committee meets weekly and reviews requests for unique needs that are not covered by the Health Benefits Card.
Pages to are hidden for
"Alberta Adult Health Benefits Brochure"Please download to view full document