The ASEBP office is open for scheduled meetings! Schedule an in-person meeting, video meeting, or phone call with a benefit specialist between 9:15 a.m. and 3 p.m. Monday to Friday, by using our Online Booking tool. Please note that the office is closed from 12:15-12:45 p.m. for lunch.

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NOTE: This information is only current as of Aug 17, 2022. Please visit asebp.ca for the most up-to-date information.

MyRetiree Plan

Flexibility. Options. Competitive Rates. That’s what you’ll get with our no-age-cap MyRetiree Plan. With above-industry-standard coverage, a competitive rate guarantee (until September 1, 2023), emergency travel insurance (up to age 85), and a referral program, our plan was created with Alberta’s education sector in mind.

For questions, schedule an in-person meeting, video meeting, or phone call with a benefit specialist today!

MyRetiree Plan Brochure

Our information brochure, which includes a competitive comparison and rates, will help clear the air so you can make an informed decision that works for you and your family.

ASEBP’s MyRetiree Plan: Benefiting you today; there for you tomorrow

 

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Coverage Options

Because everyone’s benefits needs are different and may change, it’s important to offer you a choice of coverage levels, including: 

  • Single coverage: applies to members only
  • Couple coverage: applies to member and one dependant (spouse/partner unless you advise otherwise)
  • Family coverage: applies to members and all dependants listed.

Open Enrolment

To ensure eligible former ASEBP members and surviving dependants of deceased members can receive MyRetiree Plan benefits, we have an open enrolment period until December 31, 2022, with no medical evidence required. We’ll provide more information about the open enrolment deadline as the date draws near. 

Plans

Our MyRetiree Plan offers two plans - Enhanced and Core. These plans offer mandatory Extended Health Care (EHC), Vision Care, and optional Dental Care. Life and Accidental Death & Dismemberment insurance is another consideration for those under 65.  

Enhanced: Offers increased coverage levels, such as per-visit and yearly maximums. This plan is a great option for members without additional coverage through a secondary plan (i.e. spousal plan through another provider). 

You should be aware that the Enhanced plan requires you to maintain a minimum level of Single coverage for a 2-year period, at which point, you may reduce to the Core plan. You can choose to cancel at any time; however, you forfeit the right to participate in the future if you terminate your coverage. 

Core: While still offering comprehensive coverage, the per-visit and yearly maximums are reduced to align with this plan’s lower premium rates. Our Core plan is a great option as a top-up to a supplemental plan.  

Life and Accidental Death & Dismemberment (AD&D): Life Insurance and AD&D insurance is available to previous or existing covered members under 65.  

Extended Health Care: Mandatory

Extended Health Care (EHC) is mandatory and includes coverage for Drugs, Other Medical Services & Supplies, Vision Care , and Emergency Travel Insurance

Drugs

The Alberta School Employee Benefit Plan (ASEBP) offers comprehensive drug coverage for the MyRetiree Plan. Here are the basic eligibility criteria for prescription drugs: 

  • Prescribed by a doctor or other licensed health care provider in Canada
  • Dispensed by a licensed Canadian pharmacy
  • Purchased in Canada and while you or your dependants are covered under the plan
  • Being used for their intended purpose as defined by Health Canada 

If you are an ASEBP covered member, you can find your plan details on My ASEBP or My Benefits on the My ASEBP Mobile App plus specific drugs details using our Drug Inquiry Tool. Note: over-the-counter drugs, even if prescribed, are not eligible for coverage. 

The amount of coverage applies to the brand or generic, least-cost alternative, preferred alternative, or Therapeutic Alternative Reference Price (TARP), depending on the drug. Maximums and percentages reimbursed are noted where applicable.  

ENHANCED CORE

50-64 Years

  • No yearly maximum
  • Per person per calendar year (January-December)
  • 100% reimbursed for eligible drug claims

Over 65 (Alberta Seniors Benefit plan is first payor)

  • *Yearly max $5,000 (applies to dependants regardless of age)
  • Per person per calendar year (unless otherwise noted)
  • 100% for eligible drug claims

50-64 Years

  • No yearly maximum 
  • Per person per calendar year (January-December)
  • 70% reimbursement for eligible claims up to $20,000 
  • 100% reimbursement for eligible claims beyond $20,000

Over 65 (Alberta Seniors Benefit plan is first payor)

  • *Yearly max $3,500 (applies to dependants regardless of age)
  • Per person per calendar year (unless otherwise noted) 
  • 70% reimbursed for eligible drug claims 

*If you join the plan after age 65: drug maximums are effective upon enrolment. If you’re already enrolled in the MyRetiree Plan when you turn 65, drug maximums become effective on January 1 following your 65th birthday.

 

Note that the following is a comprehensive summary of the official, legally binding ASEBP insurance policies and plan documents available through your employer or by contacting us

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Advisories

Health Canada drug advisories

Biosimilar Drugs

Biosimilar drugs are cost-effective, “highly similar” copies of brand name biological drugs whose patents have expired. Health Canada reviews and approves biosimilars to ensure their safety and effectiveness. 

The Alberta government’s Biosimilars Initiative will soon result in the replacement of some brand name drugs with biosimilar drugs, when possible. This required change only applies if adult patients (those over 18 and not pregnant) have coverage under an Alberta government sponsored drug plan. The existing replacement list (of brand name drugs to biosimilars) is fairly small, with the required switch dates ranging from early- to mid-2022.  

This change won’t affect your ASEBP benefits, at this time; however, if you have coverage under multiple plans, we encourage you to check what changes, if any, your other service provider may implement now or in the future. 

Visit the Government of Alberta’s Biosimilars Initiative for more information. 

Brand and Generic Drugs

Brand drugs are patented and manufactured by a pharmaceutical company under a particular name. Generic drugs are essentially copies of brand name drugs. They have the same dosage, strength, delivery method (e.g. oral, intravenous, etc.), quality, performance and intended use. In most cases, generic drugs become available after the patent for the original manufacturer of the brand expires. 

Dispensing Fees and Compound Drugs

Dispensing fees are charged by the pharmacy to prepare your medication and can vary between pharmacies. Maximums are a flat rate and are included in the total cost of the prescription. You are responsible to cover any difference in the fee charged by the pharmacy and what ASEBP has set for the maximum. 

  • $9 for drugs and prepackaged compounds
  • $13.50 for compounds 

Compounds are a mixture of one or more drug ingredients prepared by the pharmacist when you pick up your prescription. Prepackaged compounds come to the pharmacy from another compounding pharmacy already assembled. It’s important to note that all drug ingredients in the compound must be eligible under the plan for the drug to be eligible for coverage. The compound cannot duplicate a commercially available prepackage medication. 

Dispensing for Maintenance Medications

Maintenance medications are drugs prescribed to patients with chronic health conditions or prescriptions that can be managed on a long-term basis. See Maintenance Medication Program for details and a complete list of drug classes considered maintenance medications by ASEBP. 

If you refill a prescription beyond the allocated five refills per year, this may result in out-of-pocket dispensing fee expenses for you. If you are an ASEBP covered member, see the Drug Inquiry Tool on My ASEBP or the My ASEBP Mobile App to determine if a specific drug is listed as a maintenance medication. 

  • five refills per prescription per calendar year 

Early Refills

A prescription refill is considered early at any time prior to 70 per cent of an existing prescription being used. So, if you have a 90-day prescription, you’d have to be at least 63 days into it before you will be eligible for a refill. Let your pharmacist know if you have extenuating circumstances (e.g. your medication was lost or stolen) as pharmacies can make allowances. 

Early Refills for Travel 

Before you leave on a trip outside of Canada, you should refill any prescriptions you may need while you’re away. If you need more than a 100-day supply of your prescription, you’ll need to use the Greater than 100 Day Supply of Prescription Drugs Request prior to visiting your pharmacy. 

Enhanced Special Authorization

Any enhanced drug special authorization(s) in place for you and any dependants will terminate January 1 after your 65th birthday. As a member of our MyRetiree Plan, your regular drug coverage will remain in place.  

There is a different authorization process for specialty drugs used to treat the following seven health conditions: 

  1. Ankylosing spondylitis 
  2. Chronic hepatitis C 
  3. Crohn’s disease/colitis 
  4. Multiple sclerosis 
  5. Psoriasis 
  6. Psoriatic arthritis 
  7. Rheumatoid arthritis 

This process ensures physicians escalate therapies for these seven health conditions in a safe, gradual, and cost-effective way. Our focus on the health conditions allows us to better see all aspects of our covered members’ health experiences and positions us to support them using all the health care tools, benefits, and resources available through the plan. 

New prescriptions 

If you have a new prescription for a drug used to treat one of the health conditions above, and the Drug Inquiry Tool on My ASEBP indicates it requires an enhanced special authorization to be eligible for coverage, please follow the steps below: 

  1. Discuss treatment options with your specialist. 
  2. Download the form that applies to your condition. 
  3. Complete and sign the patient section of the form (Part 1). 
  4. Provide the form to your specialist. They will complete their section of the form and submit to us. 
  5. We will advise you and your specialist whether the drug will be covered.  

Here’s some important information for you to know: 

  • Doctors or support groups may provide you complimentary doses of a specialty drug to take before you get approval that the drug will be covered. Be advised that simply taking the drug is not a guarantee of coverage approval and that some specialty drugs are not easy to stop taking. So, if you start a course of treatment before receiving enhanced special authorization approval from us, there is a chance that coverage will not be approved, and you will be responsible for the cost. 

  • If the drug you’ve been prescribed says it requires enhanced special authorization on the Drug Inquiry Tool on My ASEBP but you’re not taking it for one of the seven conditions listed above (e.g. cancer, hemophilia, polyarticular juvenile idiopathic arthritis, hidradenitis suppurativa, etc.), you are not required to apply for enhanced special authorization. Your doctor will manage this process for you. 

Renewing your Enhanced Special Authorization 

You’ll have to renew your application for enhanced special authorization approval annually. Please follow the steps below to renew: 

  1. Once you receive notification that your enhanced special authorization is due to renew, download the form that applies to your condition. 
  2. Complete and sign the patient section of the form (Part 1, sections A & B only). 
  3. Provide the form to your specialist. They will complete the form (Part 2, sections A & F only) and submit to us. 
  4. We will advise you and your specialist whether or not the renewal is approved, and the drug will continue to be covered. 

Important Information For You to Know 

  • Special Authorization approvals require active Extended Health Care coverage. If your employment is contractual, your coverage for the medication may be interrupted. Contact us for clarification. 
  • Chronic hepatitis C is not eligible for renewal as it is a one-time treatment. 
  • If you haven’t already, please register with My ASEBP using your personal email address (instead of your work email). This way, you can access any important information on the status of your enhanced special authorization at any time.  

Erectile Disfunction Drugs

Every calendar year (January to December), you and your dependants are covered at 100% (Enhanced) or 70% (Core) and can each access up to $100 per month, to a maximum of $1,000 per person per calendar year.

Joint Injectable Materials

Every calendar year (January to December), you and your dependants are covered at 100% (Enhanced) or 70% (Core) for the cost of eligible drugs and materials used to treat osteoarthritis, to a maximum of $1,000 per person per calendar year.

Please contact us for eligibility details on specific drugs.

Least Cost Alternatives

The coverage level for many prescription drugs is based on the Least Cost Alternative (LCA)—the lowest cost brand or generic drug alternative to what was prescribed by your health care provider. The LCA must have the same dosage, strength, delivery method (e.g. oral, intravenous, etc.), quality, performance and intended use as what you were prescribed. 

If you choose to fill the prescription, which is not the lowest cost brand or generic drug alternative, this may result in out-of-pocket expenses for you. 

Life Sustaining Over-the-Counter Exception List

ASEBP created a defined Life-Sustaining over-the-counter exceptions list for urgently needed, life-sustaining situations because we are required to limit coverage to medically exempt tax benefits. These categories include injectable epinephrine, insulin, injectable glucagon kits, nitroglycerin rescue treatments and potassium supplements.

Enhanced Plan Core Plan
  • 100%
  • 70% reimbursement for eligible claims up to $20,000
  • 100% reimbursement for eligible claims beyond $20,000 

Maintenance Medication Program

Drugs prescribed to patients with chronic health conditions or prescriptions that can be managed on a long-term basis are considered maintenance medications. As these drugs are usually taken continuously over a long period of time, there is a low likelihood that the dosage will change. 

ASEBP’s Maintenance Medication Program considers drugs in the following nine classes maintenance medications. Drugs within these classes have a maximum of five dispensing fees (the amount your pharmacy charges to fill your prescription) allowed within a calendar year (January 1 – December 31). This encourages you to fill a three-month’s supply of your medication at one time—lessening the risk of missing doses between fills—and gives you a safe, simple and affordable way to help keep the plan comprehensive and sustainable over the long term. 

  1. High blood pressure medications 
  2. Mood elevating medications (anti-depressants)
  3. High cholesterol medications 
  4. High blood sugar medications 
  5. Birth control medications 
  6. Abnormal thyroid medications 
  7. Asthma or Chronic Obstructive Pulmonary Disease (COPD) medications
  8. Hormone replacement medications
  9. Overactive bladder medications

If you choose to have your prescription for a maintenance drug filled more than five times during the year, you will be responsible to pay the entire dispensing fee portion of the total prescription cost out-of-pocket after the fifth fill (the drug portion will continue to be covered by your plan). In some circumstances, your prescription won’t allow for a three months supply (e.g. blister packaging and/or other medical reasons). In these cases, your pharmacist will be able to help you to obtain any required approvals. Your pharmacy is notified that you have a limited number of dispensing fees for that drug per calendar year and will be able to tell you how many refills you have before you’re responsible to pay the entire dispensing fee. 

Visit the Drug Inquiry Tool on My ASEBP to see if a drug you’ve been prescribed falls within the Maintenance Medication Program. 

Migraine Medications

Approval of migraine medications, including Emgality and Aimovigis, are subject to Alberta Blue Cross Special Authorization criteria. Patients must request that their specialist (i.e. neurologist) complete the Special Authorization form and submit it directly to Alberta Blue Cross for review and approval. ASEBP doesn’t need to review or receive copies of Special Authorization forms. See the Drug Inquiry Tool on My ASEBP for eligibility details on specific drugs. 

Enhanced Plan Core Plan
  • 100%
  • 70% for eligible claims up to $20,000
  • 100% for eligible claims beyond $20,000 

Sclerotherapy

Your plan includes the cost of drugs used for procedures to treat varicose and spider veins. See the Drug Inquiry Tool on My ASEBP for eligibility details on specific drugs.

It’s important to note that ultrasound-guided sclerotherapy treatment is not covered.

Enhanced Core
  • 100%
  • 70% for eligible claims up to $20,000
  • 100% for eligible claims beyond $20,000 

Smoking Cessation

See the Drug Inquiry Tool on My ASEBP for eligibility details on specific prescription drugs. You can also visit Alberta Quits for additional support. 

Enhanced Core
  • 100% to a lifetime maximum of $1,500 per person
  • 70% to a lifetime maximum of $1,500 per person

Special Authorization

Some drugs require special authorization or a review to be eligible for coverage. If your pharmacist has told you that your prescription requires special authorization, you will likely either: 

  1. be asked to go back to your doctor or other licensed health care provider who wrote you the prescription to have them complete a special authorization form (they have easy access to this form), or 

  1. be assisted by your pharmacist in contacting your doctor or other licensed health care provider who wrote you the prescription to have them complete the form. You and your doctor will be notified once a decision is reached on whether or not the prescribed drug will be covered.  

Your pharmacist will be able to tell you if your authorization needs to be renewed, but generally you won’t be responsible for initiating that process. Keep in mind that over-the-counter products and specific brands of interchangeable drugs are not eligible for special authorization. 

You can visit the Drug Inquiry Tool on My ASEBP to see if a drug you’ve been prescribed requires special authorization. 

Step Therapy Program

The Step Therapy Program promotes the use of what we call "first-line" drugs for select medications used to treat overactive bladder, asthma and diabetes/blood sugar management. Considered less invasive than "second-line" drugs, first-line drugs also cost less. Within this program, you will need to show that you have tried the first-line drug before the second-line drug will be available for coverage. If the first-line drugs were not effective, caused adverse reactions or you have a medical condition that may have a negative interaction, the second-line drugs will be eligible for you. In these cases, a special authorization is required.  

Visit the Drug Inquiry Tool on My ASEBP to see if a drug you’ve been prescribed is included in the Step Therapy Program. 

Vaccines

Your plan includes coverage for particular preventative and travel vaccines. Be sure to access your provincial health care insurance plan or other government programs that offer free or subsidized vaccines (e.g. flu vaccine) prior to submitting a claim. See the Drug Inquiry Tool on My ASEBP for eligibility details on specific vaccines.

Enhanced Core
  • 100%
  • 70% for eligible claims up to $20,000
  • 100% for eligible claims beyond $20,000 

Therapeutic Alternative Reference Pricing

ASEBP’s Therapeutic Alternative Reference Pricing (TARP) program encourages cost-effective prescribing for four common medical conditions. The program identifies “preferred” drugs to treat the following: 

  • Stomach hyperacidity 
  • High blood pressure 
  • Pain/inflammation management (non-narcotic) 
  • Migraines 

All the medications identified as preferred alternatives have similar active ingredients to their brand or generic counterparts and are proven equally safe and effective. You can visit the Drug Inquiry Tool on My ASEBP to see if a drug you’ve been prescribed has preferred alternatives under the TARP program. 

If the drug you’ve been prescribed falls into one of the four categories listed above and has preferred alternatives, you have two options: 

  1. You can choose to start taking the preferred drug instead of the one you were prescribed, and you’ll be covered as you would usually under your plan, or 
  2. You can choose to start taking or remain on the drug you were originally prescribed and pay for the cost difference between the prescribed and the preferred drug either out-of-pocket, through your benefits with another health care provider or through a spending account if you have access to one. 

If you can’t take the preferred drug for medical reasons (e.g. you have an allergy), the doctor or other licensed health care provider who wrote the prescription can submit a special (pricing) authorization request on your behalf—they have easy access to the required form. If approved, this authorization will ensure you’re covered for the prescribed drug within the limits of your plan. 

If you choose to remain on your prescribed drug, pay out-of-pocket for the difference, and then have your health care provider submit a special authorization to ASEBP for review afterward, understand that: 

  1. The submission of the authorization is not a guarantee of approval, and 
  2. If approved, the authorization takes effect on the first day of the month that your approval was granted and not the date you filled your prescription or made the claim. 

What's Not Covered

Only drug products or supplies specifically listed as covered in the Drug Inquiry Tool may be reimbursed and are subject to any limitations, maximums or exclusions as indicated. The following are a number of products and/or services not covered under the plan. Note that this list is not exhaustive.  

  • Experimental drugs 
  • Drugs or indications of use that are not approved by Health Canada 
  • Vitamins, minerals, or herbal drugs 
  • Over-the-counter drugs that are not on the life-sustaining over-the-counter exceptions list (e.g. low dose aspirin) 
  • Administration fees for drugs such as Botox (migraines) and joint injectables 
  • Early refills for drugs without any extenuating circumstances 
  • Treatment that is experimental, educational or for the purpose of research 
  • Treatment provided free of charge 
  • Non-emergent drugs purchased outside Canada 
  • Expenses covered through a government program, whether or not you or your dependants choose to participate in the program 
  • Medical services and supplies provided by a dental or medical department in which there is a conflict of interest (e.g. maintained by the employer, a mutual benefit association, labour union, trustee or similar type of group) 
  • Expenses incurred while on active duty in any military or peacekeeping force 
  • All coverage where your conduct would constitute an indictable offence within Canada 

Other Medical Services and Supplies

ASEBP’s MyRetiree Plan provides coverage for a variety of medical services and supplies that complement your provincial health care insurance plan and your Coverage for Seniors program (if 65 and over). 

Here are some things you should know about your Other Medical Services & Supplies coverage: 

  • Differences and exceptions between the Enhanced and Core plans are outlined in the specific services and supplies) 
  • Some of the services and supplies included are also partially covered by your provincial health care insurance plan and/or Coverage for Seniors program 
  • While all services and supplies must be medically necessary, a doctor's referral and/or prescription are not required for reimbursement, unless otherwise specified 
  • Non-emergency services received outside of Canada are only covered if the health care provider has the proper qualifications (i.e. licensed to practice)—which is the individual’s responsibility to ensure 
  • Medical supplies purchased outside of Canada are covered, unless otherwise specified  

Note that the following is a comprehensive summary of the official, legally binding ASEBP insurance policies and plan documents available through your employer or by contacting us

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Accidental Dental

  • Enhanced 100%
  • Core 70%

You and your dependants each have a maximum of $1,000 per tooth for dental treatment due to accidental injury (both inside and outside of Canada). 

Note that accidental dental claims do not affect your annual or lifetime dental coverage limits. If you receive dental treatment due to accidental injury, please have your dentist complete the “Dental Accident” section of the Dental Care Claim. If the form you’re using does not have a specific section for accidental dental information, please mark the claim “Dental Accident” to prevent expenses from being applied to your annual dental maximum. Please ensure your dentist identifies all injured teeth on the form along with the date and details of the accident. 

If services exceed the $1,000 per tooth maximum and you’re inside of Canada, your claim can be submitted under your Dental Care benefits and will be applied to your annual or lifetime dental claim maximums. If services exceed the $1,000 per tooth maximum and you’re outside of Canada, your claim may be covered under your Travel Emergency benefits. 

Requirement(s):  

  • Must be necessary for the treatment of either accidental dental injury due to an external blow to the mouth or damage caused by biting on a foreign object inserted in the mouth 
  • Treatment must be completed within two years of the accidental injury date 
  • Damage must not have existed prior to the accidental injury 

Acupuncture

  • Enhanced 100%
  • Core 70%

Every calendar year (January to December), you and your dependants can each access your plan’s maximums of $500 per person (Enhanced) and $300 per person (Core), up to $65 per treatment per day, for acupuncture services. You can easily track your expenses and view your usage summary on My ASEBP or the My ASEBP Mobile App

Requirement(s):  

  • No prescription required 
  • Must be provided by an acupuncturist registered in the province of practice 

Exclusion(s): 

  • No more than one treatment per day (per person) 

Aerochambers

  • Enhanced 100%
  • Core 70%

Every calendar year (January to December), you and your dependants can each access your plan maximum of $40 per person towards the purchase of an aerochamber. Inhalers are covered separately. 

Exclusion(s): 

  • Repairs 

Allergy Testing Materials

  • Enhanced 100%
  • Core 70%

Every calendar year (January to December), you and your dependants each have a maximum of $40 towards the purchase of allergy testing materials. 

Ambulance

  • Enhanced 100%
  • Core 70%

Coverage is for professional ambulance services (ground and air)—regardless of whether or not you’re transported after treatment—at the rates negotiated between ASEBP and Alberta Health Services (AHS). Note that claiming practices may affect the time in which your claim is processed. 

Requirement(s):  

  • Must be used for the emergency treatment and/or transport of a patient to the nearest hospital that can provide adequate medical treatment and when no other means of transportation is appropriate 
  • Ambulance services provided in a province other than Alberta are covered to the price negotiated within that province 
  • If you receive an invoice from the provider, call EMS Accounts Receivable at 1-877-506-3230 as you shouldn’t pay the provider directly because ASEBP has a direct billing agreement with ambulances 

Exclusion(s): 

  • Trips that are: 
    • not an emergency 
    • to a treatment facility that is not active 
    • between active treatment facilities (the sending hospital is responsible for this fee) 
    • to or from a nursing home 
    • pre-arranged or pre-booked 
  • Additional fees (e.g. late payment charges, surcharges, escort charges, medications or other charges such as the Jaws of Life, etc.) 
  • Fire department response fees 

Claiming Practice

In order to direct-bill ASEBP for ambulance services, you must provide AHS with your ASEBP ID number during pick-up and transport. If you’ve provided AHS with your ID number and received an invoice from AHS, please contact them to bill ASEBP directly instead. 

If you do not provide your ID number during pick-up and transport and pay AHS for the service directly, you must request a refund from AHS and have them bill ASEBP directly using your ID number in order to be reimbursed. If you do not request a refund and you submit the claim to ASEBP for reimbursement, ASEBP will only reimburse at the rates negotiated between ASEBP and AHS. 

Blood Pressure Monitors

  • Enhanced 100%
  • Core 70%

Based on a rolling three-year period, you and your dependants each have a maximum of $150 towards the purchase of a digital blood pressure monitor. 

Exclusion(s):  

  • Repairs 

Brace

  • Enhanced 100%
  • Core 70%

Based on a rolling two-year period, you and your dependants each can be reimbursed for a maximum of one brace per body part (e.g. left ankle, right ankle, left wrist, right wrist, back), to a maximum of $500 per brace. A brace is a device or appliance used to support limbs or other body parts. 

Requirement(s):  

  • If applicable, your receipt must state the side (left or right) of the body that the brace is intended for 

Exclusion(s): 

  • Splints, which keep an injured body part immobile for healing purposes and are often temporary 

Canes, Casts, Cervical Collars, Crutches and Walkers

  • Enhanced 100%
  • Core 70%

Every calendar year (January to December), you and your dependants each have a combined maximum of $100 towards the purchase and/or rental of canes, casts, cervical collars, crutches and walkers. Canes, casts, cervical collars, crutches and walkers are covered up to $40 per one item for each category.  

Exclusion(s): 

  • Repairs 
  • Splints 

Chiropractor

  • Enhanced 100%
  • Core 70%

Every calendar year (January to December), you and your dependants can each use up to $500 (Enhanced) or $300 (Core) towards chiropractic services. Chiropractic treatments, including X-rays related to treatment and telephone and video calls, will be covered up to $50 a day per person. You can easily track your expenses and view your usage summary on My ASEBP or the My ASEBP Mobile App

Requirement(s):  

  • Must be provided by a chiropractor registered in the province of practice 

Exclusion(s): 

  • No more than one treatment per day (per person) 

Compression Garments and Support Surgical Stockings

  • Enhanced 100%
  • Core 70%

Every calendar year (January to December), you and your dependants each have a combined maximum of $250 towards the purchase of medically necessary compression garments (gloves, sleeves, support hosiery and surgical stockings). 

Requirement(s):  

  • Support hosiery, gloves, sleeves and surgical stockings require a minimum gradient of 20-30mmHg 
  • Receipts must include pressure gradient 
  • Only gloves, sleeves, support hosiery and surgical stockings are covered

Diabetic Supplies

  • Enhanced 100%
  • Core 70%

Every calendar year (January to December), you and your dependants can each apply your per person maximum of $4,000 towards the purchase of alcohol swabs, glucose monitors, lancets, penlets and syringes. Additionally, if you or your dependants have insulin-dependent diabetes, you can use your maximum to purchase a flash glucose monitor (e.g. FreeStyle Libre) based on a rolling two-year period and 30 sensors based on a rolling one-year period. Insulin pumps, continuous glucose monitoring receivers/transmitters and insulin are covered separately. 

Note: dispensing fees for Continuous Glucose Monitoring supplies (i.e. Dexcom and FreeStyle Libre products) will not be covered as of February 1, 2022. 

Exclusion(s): 

  • Batteries 
  • Glucose control solution 

Dressings, Bandages and Related Supplies

  • Enhanced 100%
  • Core 70%

Every calendar year (January to December), you and your dependants can each apply your per person maximum of $600 towards the purchase of dressings, bandages, and related supplies. 

Requirement(s): 

  • Must be necessary as a result of a chronic medical condition 
  • Must be pre-approved by ASEBP prior to purchase (please contact us for pre-approval requirements) 

Endovenous Laser, Radiofrequency Endovenous Ablation Therapy or Treatment with Medical Adhesives

  • Enhanced 100%
  • Core 70%

You and your dependants can each apply your per person lifetime maximum of $4,000 towards the treatment of varicose veins by endovenous laser, radiofrequency endovenous ablation therapy or with medical adhesives (e.g. VenaSeal). 

Requirement(s):  

  • Must be provided by a doctor or other licensed health care provider 

Exclusion(s):  

  • Ultrasound-guided sclerotherapy treatment 

Foot Orthotics

  • Enhanced 100%
  • Core 70%

Every calendar year (January to December), you and your dependants each have a maximum of $200 (Enhanced) and $100 (Core) towards the purchase of foot orthotics and/or arch supports. 

Requirement(s):  

  • Orthotics and arch supports must be custom made and individually fitted 

Exclusion(s): 

  • Repairs 
  • Heel lifts 
  • Off-the-shelf products (e.g. Birkenstock, Blundstone, etc.) 

Hair Pieces and Wigs

  • Enhanced 100%
  • Core 70%

Based on a rolling three-year period, you and your dependants can each apply your per person maximum of $600  towards the purchase of hairpieces or wigs. 

Requirement(s): 

  • Only for hair loss due to radiation, chemotherapy or other serious medical conditions 
  • Must be pre-approved by ASEBP prior to purchase (pleasecontact us for pre-approval requirements) 

Hearing Aids

  • Enhanced 100%
  • Core 70%

Based on a rolling three-year period, you and your dependants can each apply your per person maximums of $3,000 (Enhanced) and $1,500 (Core) towards the following hearing-related supplies and services: 

  • Hearing tests (maximum of $70 on a rolling three-year period) 
  • Purchase, repair and/or replacement (not accident-related) of hearing aids and related supplies. 
    • Damages caused by an accident: You and your dependants each have a lifetime maximum of $3,000 ($1,500 for MyRetiree Core Plan) for expenses resulting from accident-related damages 
  • Batteries for cochlear implants 

Exclusion(s): 

  • Batteries for hearing aids 
  • Cochlear implant devices 

Home Nursing Care

  • Enhanced 100%
  • Core 70%

Every calendar year (January to December), you and your dependants each have a maximum of $10,000 for home nursing care (e.g., private-duty professional nursing services provided in the home) within Canada. Expenses are part of a per person lifetime maximum of $25,000 for home nursing care within Canada. 

Registered nurses and graduate nurses will be covered up to $42 per hour; registered licensed practical nurses will be covered up to $27 per hour. 

Requirement(s): 

  • Must be provided by a registered nurse, graduate nurse or registered licensed practical nurse  
  • Must be deemed as an appropriate service or course of treatment by your doctor or other licensed health care provider (e.g. occupational therapist) 
  • Must be pre-approved by ASEBP prior to service (please contact us for pre-approval requirements) 

Exclusion(s):  

  • Homemaker, homecare services and custodial care (e.g. assistance for bathing, house cleaning, meal prep, etc.) 

Hospital Beds

  • Enhanced 100%
  • Core 70%

You and your dependants can each apply your per person lifetime maximum of $3,000 towards the purchase or rental of a hospital bed. Hospital beds allow for variable angles of incline and are easily raised or lowered to assist the patient and caregivers. Hospital beds are meant for single occupancy and allow for additional options such as IV hooks, safety rails and overbed tables. 

Requirement(s): 

  • Must be necessary as a result of a chronic medical condition 
  • Must be pre-approved by ASEBP prior to purchase (please contact us for pre-approval requirements) 

Exclusion(s): 

  • Beds (including adjustable beds) that do not qualify as “hospital beds” 

Hospital Room

You and your dependants are each covered at 100% (Enhanced) or 70% (Core) up to the Government of Alberta’s daily rate for a semi-private hospital room within Canada. Private rooms will be covered up to the semi-private room rate.  

Requirement(s): 

  • Service must be from an institution regarded as an accredited hospital. To be recognized as a hospital, the institution must: 
    • be accredited as a hospital by the Canadian Council on Hospital Accreditation, 
    • be approved for resident in-patient care under a provincial hospital services program, 
    • be primarily engaged in the in-patient medical care and treatment of sick and injured persons, 
    • provide medical, diagnostic and major surgical facilities, and 
    • provide 24-hour-a-day nursing service. 

Exclusion(s): 

  • Services from an institution not regarded as an accredited hospital, including: 
  • An institution which is primarily a home for the aged, rest home or nursing home, 
  • A facility solely dedicated to addiction treatment, 
  • A facility that operates under the Mental Health Act, and 
  • An institution operating primarily as a school or furnishing custodial care (e.g. auxiliary hospital, palliative care or respite room). 

Ileostomy, Colostomy, and Urinary Incontinence Supplies

  • Enhanced 100%
  • Core 70%

Every calendar year (from January to December), you and your dependants can each apply your individual combined maximum of $1,000 towards the purchase of ileostomy, colostomy, and urinary incontinence supplies. 

Requirement(s):  

Exclusion(s): 

  • Tubing 
  • Skincare products 

Insulin Pumps and Continuous Glucose Monitoring Receivers/Transmitters

  • Enhanced 100%
  • Core 70%

Based on a rolling four-year period, you and your dependants each have a combined maximum of $5,000 towards the purchase of insulin pumps and continuous glucose monitoring receivers/transmitters. Other diabetic supplies and insulin are covered separately. 

Exclusion(s): 

  • Batteries 
  • Glucose control solution 

Intravenous Supplies

  • Enhanced 100%
  • Core 70%

Every calendar year (January to December), you and your dependants each have a maximum of $150 towards the purchase of intravenous supplies (e.g. hep-locks, IV solutions, IV tubing, needles and swabs). 

Joint Injectable Materials

  • Enhanced 100%
  • Core 70%

Every calendar year (January to December), you and your dependants can each use up to your individual maximums of $1,000 for joint injectable materials. Please contact us for eligibility details on specific drugs.

Massage Therapy

  • Enhanced 100%
  • Core 70%

Every calendar year (January to December), you and your dependants can each use up to your individual maximum of $500 (Enhanced) and $300 (Core) for massage therapy services. Massage therapy treatments will be covered for up to $75 a day per person. 

You can easily track your expenses and view your usage summary on My ASEBP or the My ASEBP Mobile App. 

Requirement(s): 

  • Must be provided by a massage therapist registered in the province of practice (all of Canada) and have a minimum of 2,200 hours of training or equivalent competency (Alberta only) 

Exclusion(s): 

  • No more than one treatment per day (per person) 
  • Services provided by massage therapy students—even if they’re registered with a professional college or association

Naturopath

  • Enhanced 100%
  • Core 70%

Every calendar year (January to December), you and your dependants each have a maximum of $200 for naturopathy services including telephone and video call sessions. Naturopathy treatments will be covered up to $20 a day per person. 

Requirement(s): 

  • Must be provided by a naturopathic practitioner registered in Alberta or a member of the Canadian Naturopathic Association (for those provinces where there is no licensing body) 

Exclusion(s): 

  • No more than one treatment per day (per person) 
  • Naturopathic medicines 

Orthopedic Shoes

  • Enhanced 100%
  • Core 70%

Based on a rolling two-year period, you and your dependants each have a maximum of $1,500 (Enhanced) or $750 (Core) towards the purchase of orthopedic shoes. 

Requirement(s): 

  • Prescription required 
  • Must be necessary because of an anatomical deformity, and a physician's letter/prescription stating the anatomical deformity is required with claim submission 
  • Shoes must be custom made and individually fitted—if a brace is attached to the shoe, the brace must extend partway up the leg 

Exclusion(s):  

  • Repairs 
  • Off-the-shelf products (e.g. Birkenstock, Blundstone, etc.) 

Out-of-Province Treatment

Coverage for out-of-province specialized treatment expenses for you and your eligible dependants are only considered if not available in Alberta. 

Requirement(s): 

  • Specialized treatment you seek is available within Canada but outside Alberta 
  • The Alberta Health Care Insurance Plan acknowledges the treatment and accepts the expense for reimbursement 
  • Must be pre-approved by ASEBP prior to treatment (please contact us for pre-approval requirements) 
  • Must be for an expense eligible under your ASEBP benefits (e.g.: a hospital stay, or medication received while out of province) 

Exclusions: 

  • Outside of Canada treatment 
  • Out-of-province purchase of products and services that are not eligible under your ASEBP benefits 

Oxygen and Supplies Required for Its Use

  • Enhanced 100%
  • Core 70%

Every calendar year (January to December), you and your dependants each have a maximum of $1,000 towards the purchase, repair, rental and/or shipment of oxygen and supplies required for its use. 

Phototherapy Light

  • Enhanced 100%
  • Core 70%

You and your dependants each have a lifetime maximum of $300 towards the purchase of one phototherapy light. 

Requirement(s):  

  • Must be required to treat seasonal affective disorder, and a physician's letter/prescription stating the diagnosis must be included with the claim submission 

Exclusion(s): 

  • Batteries 
  • Repairs 
  • Replacement bulbs 

Physical Rehabilitation Equipment

  • Enhanced 100%
  • Core 70%

You and your dependants each have a lifetime maximum of $300 towards the purchase or rental of medically necessary physical rehabilitation equipment. 

Note: for TENS machines and neuromuscular stimulators, you and your dependants each have a $150 maximum every three years up to a lifetime maximum of $300. 

Requirement(s):  

  • A physician's letter/prescription stating the diagnosis must be included with the claim submission. Please note that letters/prescriptions from physiotherapists and chiropractors do not qualify. 

Exclusion(s):  

  • Repairs 
  • Handheld massage guns or percussion massage devices

Physiotherapy

  • Enhanced 100%
  • Core 70%

Every calendar year (January to December), you and your dependants can each use up to $500 (Enhanced) or $300 (Core) for physiotherapy services. Physiotherapy treatments, including telephone and video call sessions, will be covered for up to $75 a day per person. 

You can easily track your expenses and view your usage summary on My ASEBP or on the My ASEBP Mobile App. 

Requirement(s):  

  • Must be provided by a physiotherapist registered in the province of practice 

Exclusion(s): 

  • No more than one treatment per day (per person) 

Podiatrist/Chiropodist

  • Enhanced 100%
  • Core 70%

Every calendar year (January to December), you and your dependants each have a maximum of $500 (Enhanced) or $300 (Core) for podiatric services. Podiatry treatments, including X-rays related to treatment, will be covered for up to $50 a day per person. 

Requirement(s): 

  • Must be provided by a podiatrist 
  • No prescription required 

Exclusion(s): 

  • No more than one treatment per day (per person) 
  • Facility fees 

Prosthetics

Per type of prostheses

  • Enhanced 100%
  • Core 70%

Breast Prostheses 

Every calendar year (January to December), you and your dependants each have a maximum of $400 per breast towards the purchase of breast prostheses. 

Exclusion(s): 

  • Repairs 
  • Bras 

Eye Prostheses 

Based on a rolling three-year period, you and your dependants each have a maximum of $500 towards the purchase and/or repair of eye prostheses. 

Larynx Prostheses 

Based on a rolling three-year period, you and your dependants each have a maximum of $2,000 towards the purchase and/or repair of larynx prostheses. 

Limb Prostheses 

Based on a rolling three-year period, you and your dependants each have a combined maximum of $15,000 per limb towards the purchase, repair and/or replacement of prosthetic limbs, myoelectric limbs and stockings. 

Exclusion(s):  

  • Adults are restricted to no more than one replacement per limb on a rolling three-year period. Dependants under the age of 18 are still subject to the $15,000 per limb maximum but are covered for more than one prosthesis per limb.

Psychologist

  • Enhanced 100%
  • Core 70%

Every calendar year (January to December), you and your dependants each have a maximum of $1,000 (Enhanced) or $600 (Core) for psychology services. Psychology sessions, including telephone and video call sessions, will be covered for up to $180 for the first hour and a maximum of $90 for each additional half-hour. 

Psychology services are intended to support positive mental health and well-being and for the treatment of mental, nervous or emotional conditions, such as stress, anxiety or trauma. 

For sessions less than one hour, the coverage will be prorated based on the length of the session. Group/family counselling is covered and prorated based on both the length of the session and the number of patients attending. 

Requirement(s): 

  • Must be provided by a chartered psychologist, a provisional psychologist who is under the supervision of a chartered psychologist or a person holding a Master of Social Work degree 
  • Provider must be registered in the province of practice 
  • Receipts for claim submissions must include: 
    • the provider's name, address and credentials (note: in cases of provisional psychologists, the name of the supervising psychologist must also be included), 
    • the length of each session, 
    • the amount being charged for each session, and 
    • each patient's name if more than one person is attending a session. 

Exclusion(s): 

  • No more than one session per day (per person) 
  • Services provided by counsellors 
  • Subscription-based online psychology/counselling services 

Respiratory Equipment

  • Enhanced 100%
  • Core 70%

Based on a rolling five-year period, you and your dependants each have a per person combined maximum of $1,500 toward the purchase or rental of respiratory equipment (e.g. continuous positive airway pressure (CPAP) machines, sleep apnea dental appliances, nebulizers, peak flow meters, air purifiers, etc.). 

You can easily track your expenses and view your usage summary on My ASEBP or the My ASEBP Mobile App. 

Requirement(s):  

  • For equipment used to treat sleep apnea (e.g. CPAP machines or sleep dental appliances), a sleep study indicating the following is required: 
    • Anyone 18 and older must have an apnea-hypopnea index (AHI) of 15 or greater 
    • Dependants under 18 must have an AHI of 1 or greater 
  • Sleep apnea dental appliances must be purchased—not repaired or rented 
  • Air purifiers must be required for a chronic lung condition (e.g. asthma, COPD) and intended for household use,  
    • A physician's letter/prescription stating the diagnosis must be included with the claim submission 
    • Air purifier appliances must have high-efficiency particulate air (HEPA) filter 

Exclusion(s): 

  • Batteries 
  • Chargers or charging cords 
  • Sleep studies, testing and dental examination fees 
  • Cleaning supplies 
  • Replacement filters 

Respiratory Equipment Accessories and Repairs

  • Enhanced 100%
  • Core 70%

Every calendar year (January to December), you and your dependants each have a per person maximum of $200 toward the purchase or rental of respiratory equipment accessories (e.g. tubes, masks, etc.) and repairs. A sleep study isn't required to access this coverage. 

Exclusion(s): 

  • Batteries 
  • Chargers or charging cords 
  • Cleaning supplies 

Sclerotherapy

For sclerotherapy details, please see Drugs. It’s important to note that ultrasound-guided sclerotherapy treatment is not covered. 

Ultraviolet Light

  • Enhanced 100%
  • Core 70%

You and your dependants each have a lifetime maximum of $300 towards the purchase of one ultraviolet light. 

Requirement(s):  

  • Must be required to treat psoriasis, and a physician's letter/prescription stating the diagnosis must be included with the claim submission 

Exclusion(s): 

  • Batteries 
  • Repairs 
  • Replacement bulbs 

Wheelchairs and Scooters

  • Enhanced 100%
  • Core 70%

Based on a rolling four-year period, you and your dependants each have a combined per person maximum of $4,000 toward the purchase, repair, replacement and/or rental of wheelchairs or scooters. 

Requirement(s): 

  • Must be pre-approved by ASEBP prior to purchase (please contact us for pre-approval requirements) 

Exclusion(s): 

  • Knee scooters/walkers 

What's Not Covered

Only expenses specifically listed as covered may be reimbursed and are subject to any limitations, maximums or exclusions as indicated. Here are a number of items not covered under the plan. Note that this list is not exhaustive.  

  • Magnetic Resonance Imaging (MRI) 
  • Check-ups (including screening, routine physical examinations and research studies) not necessary for treatment 
  • X-rays (unless related to chiropractic or podiatry treatments) 
  • Speech therapy 
  • Splints 
  • Beds (including adjustable beds) that do not qualify as “hospital beds” 
  • Surgical implants (e.g. breast, testicular, cochlear) 
  • Medical services and supplies (including hospital confinement) provided in association with cosmetic surgery or procedures 
  • Expenses that are not considered medically necessary for the care of the patient’s injury or illness 
  • Treatment that is experimental, educational or for the purpose of research 
  • Extra billing charges by your doctor or other licensed health care provider (e.g. missed appointment fees, fees to complete medical forms, late fees, etc.) 
  • Additional costs for medical supplies purchased from providers inside and outside Canada (e.g. shipping, duty)—unless related to oxygen and supplies required for its use 
  • Accessories and repairs (e.g. charging cords, batteries, replacement filters, etc.) 
  • Treatment and/or supplies provided free of charge 
  • Services or supplies that should be free-of-charge under legislation (e.g. charges made by doctors which are in excess of fees allowed by Health Canada
  • Expenses covered through a government program, whether or not you or your dependants choose to participate in the program 
  • Expenses acquired because of active participation in a war or act of war (declared or not) 
  • Expenses incurred while on active duty in any military or peacekeeping force 
  • Services that are self-performed or supplies that are self-prescribed by a covered member or dependant that is a health care provider (e.g. a doctor writes him/herself a prescription) 
  • Dental services other than those described under the Accidental Dental benefit 
  • All expenses incurred as a result of conduct that would constitute an indictable offence within Canada 

Vision Care

Our MyRetiree Plan offers Vision Care benefits to you and your spouse/partner and other dependants, if you have couple or family coverage, for a variety of products and services designed to help you maintain healthy eyesight. To qualify for coverage, products or services must be prescribed or provided by:  

  • registered ophthalmologist,  
  • registered optometrist, or  
  • registered optician. 

You can find your plan details under Coverage on My ASEBP or on your ASEBP ID card on the My ASEBP Mobile App under Vision Care. 

Note that the following is a comprehensive summary of the official, legally binding ASEBP insurance policies and plan documents available through your employer or by contacting us

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What's Covered

If your Vision Care claim is the result of an accident that impaired your vision, you may be eligible for reimbursement under your Accidental Death & Dismemberment benefits. 

ENHANCED CORE
  • Every rolling two years 
  • 100% to a combined maximum of $300 per person  
  • Eye exams, prescription eye glass lenses and frames, prescription contact lenses, contact lens fitting fees, prescription sunglasses, prescription safety glasses, corrective eye surgery, and lens implants 
  • Every rolling two years 
  • Covers one eye exam at 100% to a maximum of $100 per person 

What's Not Covered

The following are a number of products and/or services not covered under the plan. Note that this list is not exhaustive.   

  • Expenses covered through a government program, whether or not you or your dependants choose to participate in the program 
  • Eye exams for children up to 19 and seniors over 65 (these exams are covered through the provincial health care insurance plan as an Alberta resident)  
  • Extra billing charges or charges for missed appointments  
  • Artificial eyes 
  • Non-prescription sunglasses, non-prescription glasses and non-corrective lenses (e.g. frames for fashion purposes) 
  • Non-prescription safety glasses, lens hardening or similar treatments 
  • Services and products for cosmetic purposes (e.g. blepharoplasty, also known as eyelid lift surgery) 
  • Shipping charges or duty, when vision supplies are purchased outside of Canada 
  • Where treatment is experimental, educational or for the purpose of research 
  • Treatment and/or supplies provided free of charge (e.g. if an optometrist bills for an eye exam, ASEBP pays a portion and you or your dependant pay the remaining amount. If the optometrist does not require you or your dependant to pay your portion, ASEBP will not pay either.) 
  • Charges for products or services that are prohibited under legislation 
  • Services you perform on yourself 
  • Expenses incurred while on active duty in any military or peacekeeping force 
  • All expenses incurred as a result of conduct that would constitute an indictable offence within Canada 

Additional Information

Rolling Period

Your plan maximums for Vision Care are based on a rolling two-year period based on the service date you received the treatment, service or product being claimed, and the date the claim is paid in full—not the calendar year. (E.g. if you make a vision claim for $100 on May 15, 2022, that $100 will be added back to your vision coverage balance on May 15, 2024.)  

You can easily track your expenses and view your usage summary on My ASEBP or the My ASEBP Mobile App

Claiming Period 

Claims must be received by ASEBP within 18 months of the date the expense is incurred. Claims for expenses that are more than 18 months old will not be paid.  

Non-Emergency Goods and Services Outside Canada 

Eligible Vision Care products and services are covered if service providers have the proper qualifications for eligible services, no matter where they are located. 

Emergency Travel Insurance

Our MyRetiree Plan offers a beyond-industry-standard age cap for emergency travel insurance and is available to eligible members until the end of the month in which you turn 85. Coverage for your dependants will also cease at this time, regardless of their age. 

In the event of a medical emergency, immediately call the applicable emergency access number to speak with a medical travel advisor. Please be prepared to quote your group and identification numbers—available on your ASEBP ID card or on the My ASEBP Mobile App—as well as travel plan number 879. 

  • Toll-free in Canada and USA: 1-888-772-2583 
  • In all other countries, or if you have difficulties with the toll-free number, call collect: 1-403-225-4289 
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90-Day Stability Clause

Our stability clause means that there have been no changes to your pre-existing medical condition(s) 90 days prior to your trip date. Changes could mean an increase or decrease in medication, a new medication prescribed, hospitalization, new testing, treatment, symptoms, or a new diagnosis for your condition. 

If you have a pre-existing medical condition that isn’t stable 90 days before you leave Canada, then any claims relating to that pre-existing medical condition won’t be covered. 

COVID-19

If you are travelling, it's important to understand your Emergency Travel Insurance and how COVID-19 may impact it. Please take a moment to read through our COVID-19 travel information.

Lifetime Maximum

Following industry standards, our MyRetiree Plan has a per person lifetime maximum of $5,000,000 of emergency travel insurance.

Trip Duration Limitation

As a covered member, you can access 100% coverage over multiple trips per year up to a maximum duration of 100 days per trip. For trips extending beyond 100 days, you can purchase additional travel coverage through Alberta Blue Cross and by calling 1-800-394-1965 and press #4. Your 100 days resets upon re-entry into Canada.

Life and Accidental Death & Dismemberment Insurance

If eligible, the amount of Life and Accidental Death and Dismemberment (AD&D) insurance available to you is 2x the annual salary you had in place before retirement or terminating from ASEBP. If you did not previously participate in Life and AD&D insurance, you aren’t eligible for these benefits. Benefits paid under your Life Insurance and AD&D policies are tax-free.  

Eligibility Requirements 

  • Covered members under 65 
  • Previously participated in ASEBP’s Life and AD&D insurance 

Note that the following is a comprehensive summary of the official, legally binding ASEBP insurance policies and plan documents available through your employer or by contacting us

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Accidental Death & Dismemberment Insurance

  • The accident must be the sole cause of death or specified injury for the benefit to be considered 
  • Available only to you, the covered member (note that some benefits are payable to your spouse and dependants) 
  • Your Principal Sum is two times your annual earnings at the time of retirement to a maximum of $800,000. 

Life Insurance

  • Your Principal Sum is two times your annual earnings at the time of retirement to a maximum of $800,000. 
  • Payable to your designated beneficiary or your estate. This includes salary, administrative allowances, isolation pay, vacation pay, retroactive salary, and compensation for an acting assignment longer than three months. 
  • Note that annual earnings do not include car allowances, early retirement incentives, expense allowances or reimbursements, overtime, pay in lieu of vacation, salary from teaching night or summer school classes, or signing bonuses. 

Dental Care: Optional

While Dental Care is optional, if you choose to decline dental coverage when you initially apply for the MyRetiree Plan, you can only apply in the future if you lose spousal or alternative coverage. At that time, we’ll require proof of loss of dental coverage, which must be submitted within 31 days of losing coverage. 

Please know that you cannot enrol in just dental coverage without enrolling in Extended Health Care and Vision Care coverage. 

Oral Health 

Our dental coverage encourages you and your dependants to proactively manage your oral health through basic preventative and restorative treatments (e.g. check-ups, X-rays and cleanings, etc.).  

Plus, the Enhanced and Core plans both cover major restorative dental work (e.g. bridges and crowns, etc.) and orthodontic treatments (e.g. braces and appliances, etc.). You can find your plan details on your Alberta School Employee Benefit Plan (ASEBP) ID card on My ASEBP or the My ASEBP Mobile App

It's important to note that dental fees in Alberta aren't regulated. Learn more about what this means and how it affects your out-of-pocket costs in the Dental Fees section. 

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Dental Fees

Dental fees are the amount your dentist charges for the services they provide. Fees in Alberta are unregulated and have historically been the highest in Canada. As a result, in 2017, the Alberta Dental Association and College (ADA&C) introduced a dental fee guide to help mitigate the rising costs of oral health services in the province. While the ADA&C encourages dental providers to use this guide to set prices for their practice it isn't mandatory, meaning the cost of services can still vary between dental offices.

The ASEBP Dental Benefit List closely mirrors the ADA&C guide and outlines our reimbursement rates for all dental services based on reasonable and customary costs. So, while you may have 100 per cent coverage for certain dental services, 100 per cent of your dentist's bill may not be covered as they may charge more than what's outlined in the ASEBP Dental Benefit List.

To avoid surprises, become informed about how the expected dental fees align with your plan:

  • Before your visit, talk to your dental provider and ask them if they charge according to the ASEBP Dental Benefit List—the dental office can check coverage levels for services and procedures electronically before they submit your claims.
  • Use the Online Dental Guide on My ASEBP to determine how much of a certain service or procedure will be covered by your ASEBP Dental Care plan. Our Online Dental Guide also allows you to:
    • Learn how often your plan covers certain dental procedures
    • Lookup a service procedure code (from a treatment plan or bill) for more information
    • View the maximum amount your plan pays for specific dental services
    • Have informed conversations with your dental office about how their fees compare to the ASEBP Dental Benefit List

To access the Online Dental Guide, simply visit my.asebp.ca/DentalGuide.

Dental Predetermination

You should discuss any proposed basic or major restorative treatments with your dentist to understand both the cost of the treatment and to determine if a proposed treatment plan (dental predetermination) is needed. To avoid surprise out-of-pocket expenses, we recommend having your dentist submit a dental predetermination in advance of any proposed treatment, especially if the cost is $800 or more.
On occasion, ASEBP may request pre-treatment X-rays or other information from your dentist to support a treatment plan. Where two or more courses of treatment are submitted, reimbursement will be based on the least expensive of the proposed treatments. 

Here are some important things for you to know:

  • You can find your dental predeterminations online on My ASEBP under Documents.
  • Receiving a predetermination isn't a pre-approval for the reimbursement of your expenses. It's a confirmation that the prescribed treatment you're considering is included as part of your ASEBP coverage. 
  • Predeterminations only take into account the costs that have been accumulated against your maximum at the time of the authorization—they don't include any costs that haven't yet been billed to ASEBP or coordination of benefit rules, etc.
  • To be reimbursed for the amounts confirmed, you or your dependants must start the treatment within 90 days of your dentist submitting the predetermination to ASEBP. If your treatment began prior to you receiving ASEBP coverage, please submit a predetermination with the start date of your current treatment plan. Note that treatments incurred prior to your effective date of coverage won't be eligible for reimbursement.
  • Depending on the cost of your proposed treatment plan (whether it’s above or below $800) as well as how your dental provider submits the predetermination (e.g. mail or electronically), you may or may not receive your own copy of the predetermination. If you don't receive a copy and would like to review the predetermination and how much your ASEBP Dental Care benefits will cover, please speak with your dental provider as they'll receive confirmation of payment coverage breakdowns for all submitted predeterminations.

Major/Restorative

ENHANCED CORE

100% of the Dental Benefit List fees up to $5,000 for major treatments per person per calendar year   

50% of the Dental Benefit List fees up to $2,000 for major treatments per person per calendar year 

Orthodontics Including Predeterminations)

Note: Only available for dependants 19 and under. 

Except for diagnostic tests, ASEBP requires an orthodontic predetermination (treatment plan) to be in place and the patient is under the direct care of a licensed dental provider before reimbursing orthodontic services. Note that the treatment plan should also include payment arrangements. 

ENHANCED CORE

50% of the Dental Benefit List fees for examinations, diagnostics, and all other treatments (e.g. appliances, banding, etc.) up to $3,000 per person per lifetime

Not available 

 

 

 

 

For an orthodontic predetermination to be complete, your orthodontist must include the following information:

  • A description of the condition requiring treatment, including the classification and malocclusion (misalignment)
  • Length of time per course of treatment
  • Total cost of treatment and payment details, including:
    • if treatment will be paid as a one-time full payment, or
    • if payment will be broken down into an initial fee and instalment payments (include down payment and instalment—monthly or quarterly—amounts)

Here are some important things for you to know:

  • You can find your orthodontic predeterminations online on My ASEBP under Documents.
  • Receiving a predetermination isn't a pre-approval for the reimbursement of your expenses. It's a confirmation that the prescribed treatment you're considering is included as part of your ASEBP coverage. 
  • Predeterminations only take into account the costs that have been accumulated against your maximum at the time of the authorization—they don't include any costs that haven't yet been billed to ASEBP or coordination of benefit rules, etc.
  • To be reimbursed for the amounts confirmed, treatment must begin within 12 months of your orthodontist submitting the predetermination to ASEBP. If your orthodontic treatment began prior to you being enrolled in ASEBP dental coverage, a predetermination for any remaining work will need to be submitted and approved by ASEBP before any portion of the work will be paid.
  • If your approved treatment plan indicated you would pay an initial fee (down payment) plus instalment payments but the claim you submitted shows the treatment has been paid in one payment, your claim will be processed for the full amount you paid (up to plan limitations).
  • If your treatment plan has a specified payment plan (e.g. monthly, quarterly, etc.), the initial down payment or fee can’t exceed 1/3 of the overall cost of the treatment.
  • Please contact us if you're currently making instalment payments for a treatment plan and would like to make more than one scheduled payment but less than the full balance.
  • If you're currently making instalment payments for a treatment plan but decide you want to pay the remaining balance in full, you'll need to submit a receipt indicating the full balance has been paid with your claim.

Preventative/Basic

ENHANCED CORE

50% of the Dental Benefit List fees for basic treatments up to $2,500 per person per calendar year 

50% of the Dental Benefit List fees for basic treatments up to $2,000 per person per calendar year 

What's Not Covered

The following are a number of products and services not covered under the plan. Note that this list isn't exhaustive. 

  • Appliances which have been lost, stolen or broken because of an incident that did not involve accidental bodily injury
  • Charges for broken or missed appointments
  • Correction of temporomandibular joint (TMJ) dysfunction
  • Cosmetic treatment, such as teeth bleaching or diastema (gap) closure, unless necessitated by an accidental injury
  • Dietary planning, plaque control or oral hygiene instructions
  • Full mouth reconstructions and vertical dimension correction
  • Mouth guards worn for safety protection for sports, work or other related activities
  • Services or supplies that weren't provided by a dentist or other dental professional (e.g. services or supplies provided by an online or kiosk distributor)
  • Treatment that's experimental, educational or for the purpose of research
  • Treatment where expenses aren't considered necessary for the prevention of dental disease or correction of a dental defect
  • Treatment provided free of charge
  • Services provided by a family member if the family member has been given a discount. If you or your dependant is required to pay a portion of the cost of the services, you must pay for that portion or have your entire claim deemed ineligible (for example, if a dentist bills $300, we pay $180 (60 per cent) and you pay the remaining $120 (40 per cent). If the dentist doesn't require you or your dependant to pay your portion, we won't pay either)
  • Expenses covered through a government program, whether or not you or your dependants choose to participate in the program
  • Where charging for services or supplies is prohibited under legislation
  • Expenses incurred while on active duty in any military or peacekeeping force
  • All expenses incurred as a result of conduct that would constitute an indictable offence within Canada

Rates

Premium rates remain in effect until August 31, 2023, and can be found here.

Additional Information

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Applying For Coverage

To apply for the MyRetiree Plan, complete our MyRetiree Plan Application.

Frequently Asked Questions

Find answers to your questions in our information brochure. Have a question we haven't answered? Contact us.

Going Back to Work

If you decide to return to work after you’ve already retired, here are a few things to keep in mind:

  • Returning to an employer who offers ASEBP benefits: If you're eligible for your employer’s ASEBP benefits, and enrolment will be submitted by your employer, your MyRetiree Plan benefits will be suspended until you leave this position. If you're planning to have your MyRetiree Plan benefits reinstated, you'll need to let us know within 31 days of your last working day by completing the MyRetiree Change Application. If you don't complete the form within this time, your MyRetiree Plan benefits will be cancelled. Submitting your MyRetiree Change Application request well in advance of leaving your temporary position will help avoid any lapses in your benefits.
  • Returning to an employer who doesn’t offer ASEBP benefits: A minimum participation level of single coverage must be maintained under your MyRetiree Plan benefits. If you decide not to continue any part of your MyRetiree Plan benefits, you won't be eligible to reapply for coverage once you stop working. Use the MyRetiree Change Application to reduce or cancel your coverage.

Making Changes to Your MyRetiree Plan Benefits

Once you've enrolled in our MyRetiree Plan, you may be eligible to make some changes to your general health benefits (Extended Health Care, Vision, and Dental Care). All changes, regardless of the benefits you have, must be made using the MyRetiree Change Application.

If you select an Enhanced plan, you'll be required to maintain a minimum level of Single enhanced coverage for two years before choosing to select a Core plan; however, you may increase from Core to Enhanced at any time.

Also, you can terminate your coverage at any time; however, if you terminate your coverage, you forfeit the right to participate in our MyRetiree Plan in the future.

Paying Your Premiums

Premiums are paid monthly by pre-authorized debit withdrawals on the 15th of every month, with premiums covering benefits within the withdrawal month. Please log in to your My ASEBP account to ensure your personal email and banking information is up-to-date to avoid EFT failure fees. 

Pre-Retirement Planning Resources

Thinking about retirement? Take advantage of your Employee and Family Assistance Program (EFAP) to make sure you’re retirement-ready. Your EFAP offers a wide range of free services to help you assess or begin your retirement planning, like articles (Retire Happy, Healthy and Secure and Pre-Retirement Planning), e-courses (Preparing for your Retirement) and even coaching services through the Life Smart program. Log in to Homeweb and search “retirement” to get started. Your EFAP is only available prior to retirement and isn’t included as part of ASEBP’s Early Retirement or MyRetiree Plan benefits.

Referral Program

We are offering a promotional referral program during the open enrolment period until December 31, 2022). As an active member of ASEBP’s MyRetiree Plan, you can receive a one-time five per cent (5%) discount off your monthly premiums for 12 months if you refer someone who then becomes a member of the MyRetiree Plan. New applicants must indicate they were referred on their application form. ASEBP will not apply a missed referral once the applicant becomes a member. 

Prorated

Prorated: Benefit coverage that is prorated refers to a maximum being divided proportionally. 

Example 1: 

Psychology sessions are covered up to $100 per hour (for the first hour) and are prorated for sessions under one hour. Examples of shorter sessions are included below: 

  • A 30-minute session will be paid out at a total of $50. 
  • A 45-minute session will be paid out at a total of $75. 

Example 2: 

Group/family counselling is prorated based on both the length of the session and the number of patients attending. Please note that covered members and their dependants are not charged for other individuals in attendance. Examples of prorated group sessions are included below: 

  • One person with ASEBP MyRetiree Plan benefits attends a one-hour session with someone without ASEBP benefits. The person with ASEBP benefits will be subject to a maximum coverage of $50 (i.e. 50 per cent of $100) for this one-hour session.  
  • Two people with ASEBP MyRetiree Plan benefits attend a one-hour session. Both people will be subject to a maximum coverage of $50 each (i.e. 50 per cent of $100) for this one-hour session. 

Rolling Period

Your plan maximum is based on a rolling-year period (e.g. two years for a rolling two-year period, three years for a rolling three-year period, etc.) by service date (the date you received the treatment, service or product being claimed—not the date it was paid for)—not calendar year.

Example: 

  • If you make a respiratory claim (which has a rolling five-year period) for $100 on May 15, 2022, that $100 will be added back to your respiratory coverage balance on May 15, 2027. 

You can easily track your expenses and view your usage summary on My ASEBP or the My ASEBP Mobile App. 

What's Not Covered

  • Employee and Family Assistance Program
  • Extended Disability Benefits
  • Spending Accounts