Blue cross forms alberta 2025

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  1. Click ‘Get Form’ to open the blue cross forms alberta in the editor.
  2. Begin by entering the account holder's personal information. Fill in your last name, first name, middle name, and personal health number accurately.
  3. Provide your mailing address, including city/town, province, and postal code. If your residence differs from your mailing address, complete that section as well.
  4. List all individuals on your account by entering their names, dates of birth, and personal health numbers. If necessary, attach a separate sheet for additional entries.
  5. Indicate whether you want your Alberta Blue Cross Non-Group coverage to start on the cancellation date of any previous coverage by selecting 'Yes' or 'No'.
  6. Complete the certification section by providing your daytime phone number, work phone number, date, and signature to confirm the accuracy of the information provided.

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Like the five other Blue Cross plans in Canada, ABC Benefits Corporation operates the Alberta Blue Cross Plan in compliance with the licensing requirements of the Canadian Association of Blue Cross Plans.
Alberta-based and Alberta-grown, we are an independent, not-for-profit organization.
The Government of Alberta offers Alberta Blue Cross Non-Group Coverage to ensure all Albertans have access to an economical supplementary health benefits program which provides coverage for a variety of health related services not covered by the Alberta Health Care Insurance Plan (AHCIP).
Simply show your Alberta Blue Cross identification card as proof of coverage when ordering your prescription, and your pharmacist will take care of submitting the claim for payment.
How can I request a Certificate of Coverage? To request a Certificate of Coverage, contact your local Blue Cross and Blue Shield company. The phone number can be found on the back of your member ID card or you can visit the Contact Us section of this website.
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Your Alberta Health Care Insurance Plan (AHCIP) coverage can be used across Canada, but there are limits on what is covered. Not all health services available to you in Alberta are covered by AHCIP outside of Alberta. You should have additional travel or medical insurance when you leave Alberta.
Extended Health (required) Age0 - 965 - 69 Age Basic 0 - 9 $15.24 65 - 69 $41.22 Age Enhanced 0 - 9 $17.62 65 - 69 $69.02 Age Enhanced+ 0 - 9 $18.68 65 - 69 $78.17 Age Premium 0 - 9 $20.99 65 - 69 $148.02

how to apply for alberta blue cross for seniors