Alberta’s government is committed to making sure Albertans have world-class health care coverage that provides affordable access to essential medications. However, the cost of providing coverage for Seniors and Non-Group Coverage to Albertans is increasing by nearly seven per cent annually. In 2023-24, the cost of administering these two programs was approximately $1.3 billion. By 2026-27, the cost of providing coverage to Albertans will increase by approximately $194 million.
To address rising costs and ensure coverage can continue to be provided in the years to come, the maximum co-payment for a prescription will increase by a total of $10 over a 10-month period. Beginning July 1, 2025, the maximum co-payment will increase by $1 each month until it reaches $35 on April 1, 2026. If co-payments had increased in line with inflation, seniors would now be paying approximately $48.
“Providing Albertans with coverage for their prescription drugs ensures they have access to necessary medications. But drug coverage costs are rising, and we need to take steps to address the cost. This change will help keep those costs in check, maintain a fair and balanced cost sharing approach, and allow the government to continue offering this important coverage.”
When the new maximum co-payment comes into effect, the majority of Alberta seniors will still pay less than seniors in most other provinces. For example, an Alberta senior needing a drug that costs $900 annually will pay $270 and the government will pay the remaining cost. In B.C., the same senior would pay approximately $900, if their family income is over $31,000.
Public drug coverage in Alberta covers about 40.1 per cent of all expenditures toward prescribed drugs in the province. This is the second highest among all provinces (Ontario is 40.8 per cent), which on average accounts for 30 per cent of prescription drug expenditures.
Eligible low-income seniors can apply for financial assistance with their co-payments through the Special Needs Assistance for Seniors program. All Albertans are encouraged to consult with their pharmacist about ways to reduce their costs, such as obtaining prescription quantities of up to 100 days, when possible.
Quick facts
- The average prescription co-payment is $11.30 for Albertans with Non-group Coverage, and $8.44 for those with Coverage for Seniors. It is anticipated these average co-payments will increase to $14.31 and $9.87, respectively.
- Approximately 18 per cent of Non-Group Coverage participants are charged the maximum co-payment under the current co-payment structure, while approximately five per cent of Coverage for Seniors participants are charged the maximum co-payment under the current co-payment structure.
- Coverage for Seniors and Non-Group Coverage are Alberta government-sponsored health benefit plans that provide drug coverage and other health benefits.
- A co-payment is the portion of the prescription cost paid by Albertans who use these plans. The cost is paid to the pharmacy when the Albertan has their prescription filled, and the government covers the remaining cost.
- Approximately 760,000 Albertans 65 years and older have Coverage for Seniors. The number of seniors in the province is expected to almost double to 1.4 million by 2051.
- Approximately 75,000 Albertans younger than 65 years have Non-Group Coverage.