Important Changes to Alberta Blue Cross Coverage for Seniors
If you are 65 or older and use Alberta Blue Cross Coverage for Seniors (Group 66), there is an important change coming to the way your health benefits are billed.
Beginning October 1, 2026, Coverage for Seniors will become the payor of last resort for certain benefits.
So, what does that actually mean when you come to Active Balance Health Centre?
What is changing?
Currently, Coverage for Seniors is considered the first payor for certain covered services, including chiropractic care. Starting October 1, 2026, if you have both Coverage for Seniors and a private or employer-sponsored health benefits plan, your private plan will need to be billed first. Coverage for Seniors will then become the secondary—or “payor of last resort”—coverage for applicable benefits.
This change is part of Alberta’s Bill 11, the Health Statutes Amendment Act.
What does “payor of last resort” mean?
Think of it as changing the order in which your benefits are used.
Before October 1, 2026:
1. Coverage for Seniors → first payer = Direct billed at our front desk
2. Private/employer plan → secondary payer, where applicable = Patient self-submits for reimbursement
Beginning October 1, 2026:
1. Private/employer plan → first payer = Direct billed at our front desk
2. Coverage for Seniors → secondary/last payer, where applicable = Patient self-submits for reimbursement
At Active Balance Health Centre, we direct bill only the primary private or employer-sponsored plan. We will not direct bill Coverage for Seniors as a secondary plan. Any remaining eligible amount can be self-submitted by the patient to Alberta Blue Cross for reimbursement.
If you only have Coverage for Seniors and no private health benefits, there is no change to the order of payment for you.
What does this mean for chiropractic care?
Coverage for Seniors currently provides chiropractic coverage of up to $25 per visit, to a maximum of $200 per person each benefit year. This benefit continues to be available; the change is to the order in which coverage is applied when you have another eligible benefit plan.
For example, if you have an employer or personal extended health plan that covers chiropractic care, that plan will be billed first. Once that plan has processed the claim, you pay the remainder and self-submit for reimbursement to Coverage for Seniors, subject to its rules and annual maximums.
Your exact coverage will depend on the private plan you have and how the two plans coordinate benefits.
What about psychological services?
The same change applies to clinical psychological services covered under the Coverage for Seniors program. Coverage for Seniors currently provides up to $60 per visit, to a maximum of $300 each benefit year for eligible clinical psychological services.
If you have private or employer-sponsored psychological benefits, those benefits will be considered first beginning October 1, 2026.
Will I lose my Coverage for Seniors?
No.
This change does not remove your eligibility for Coverage for Seniors. Albertans continue to be eligible for the program beginning at age 65, provided they meet the program requirements.
The change is about which plan pays first, not whether you continue to have Coverage for Seniors.
What should I do?
There is no need to panic or make changes to your coverage right now. However, if you have both Coverage for Seniors and another health benefits plan, it is a good idea to understand what your private plan covers and what its annual maximums are. You may also want to check with your insurance provider if you are unsure how your benefits will coordinate after October 1.
At Active Balance Health Centre, we will continue to do our best to make the billing process as straightforward as possible. Because insurance companies determine eligibility, payment order and reimbursement, we cannot guarantee how much of an appointment will be covered. If you have questions about your specific coverage, we recommend contacting your insurance provider before your appointment.
And, as always, if you have questions about billing at ABHC, our Patient Care Team is happy to help.
A little billing change, a little more insurance paperwork…
We know that insurance coordination isn’t exactly the most exciting part of healthcare. We will do our best to make the process as painless as possible and leave the complicated insurance rules to the insurance companies.
The important date to remember is October 1, 2026.
Please visit Alberta Blue Cross for more information about this change or to speak to an Alberta Blue Cross representative with any questions you may have by clicking HERE.
