Forms for AHCIP and Blue CrossAlberta.ca 2026

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The document is an application form for the Alberta Blue Cross Non-Group Coverage Premium Subsidy for the year 2021-2022, based on 2020 tax information. It outlines the eligibility criteria, personal and income information required from the account holder and their spouse or partner, and authorizations for Alberta Health and the Canada Revenue Agency to verify eligibility for the subsidy. The form must be completed accurately to qualify for financial assistance with health insurance premiums.

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Click ‘Get Form’ to open it in the editor.
Begin with Section A, where you will enter your personal information. Fill in your health number, last name, first name, middle name, and current mailing address including city, province, country, and postal code.
Move to Section B to provide your income information. Indicate whether you filed an income tax return for 2020 and enter your taxable income as per line 260 of your tax return.
In Section C, certify that the information provided is accurate by signing and dating the form. Ensure you include your home and work phone numbers.
If applicable, complete Sections E through H for your spouse or partner's information similarly. Make sure they also sign where required.

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Versions	Form popularity	Fillable & printable
2020	4.8 Satisfied (35 Votes)
2019	3.8 Satisfied (31 Votes)
2013	4.2 Satisfied (39 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How to obtain a new Alberta health care card?

Use the AHCIP interactive phone system If you know your health number and your current address is in our system, you can order your card using our interactive phone system. Phone: 780-427-1432 and press 3, then follow the prompts.

What is AHCIP coverage in Alberta?

The Alberta Health Care Insurance Plan (AHCIP) provides eligible Alberta residents with full coverage for medically necessary physician services, and some dental and oral surgical health services. Your AHCIP coverage can be used across Canada, but there are limits.

How to get Alberta ID and health card?

You will need to provide proof of identification and Alberta residency with your application. You can send your application and the applicable fees to any Alberta registry agent. At the time of your next ID card service, you will be required to provide proof of Alberta residency and Canadian legal presence.

Is Alberta health care the same as Blue Cross?

While ACHIP manages eligibility and registration for government health benefits, Alberta Blue Cross administers a variety of programs on behalf of the Government of Alberta including the Coverage for Seniors and Non-Group Coverage programs.

Do Albertans automatically get blue cross when they turn 65?

Alberta Blue Cross Coverage for Seniors When an Alberta resident docHubes 65 years of age, the resident and all eligible dependants automatically qualify for premium-free Alberta Blue Cross Coverage for Seniors, sponsored by Alberta Health.

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What documents do I need for an Alberta health card?

Identity documents include: passport. permanent resident card (both sides) certificate of Indian Status issued by the Federal Government. government issued drivers license. government issued registries ID card. Canadian citizenship card.

Who is eligible for an Alberta health card?

You are eligible for Alberta Health Care Insurance Plan (AHCIP) coverage if you are: legally entitled to be in and remain in Canada and make your permanent home in Alberta. committed to being physically present in Alberta for at least 183 days in any 12-month period.

Forms for AHCIP and Blue CrossAlberta.ca 2026

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How to use or fill out Forms for AHCIP and Blue CrossAlberta.ca with our platform

See more Forms for AHCIP and Blue CrossAlberta.ca versions

Complete this form in 5 minutes or less

Got questions?

How to obtain a new Alberta health care card?

What is AHCIP coverage in Alberta?

How to get Alberta ID and health card?

Is Alberta health care the same as Blue Cross?

Do Albertans automatically get blue cross when they turn 65?

Security and compliance

Complete this form in 5 minutes or less

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What documents do I need for an Alberta health card?

Who is eligible for an Alberta health card?

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