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  • Registration For Preauthorized Monthly Payment Alberta Blue Cross Non-group Coverage Section A Plan

Get Registration For Preauthorized Monthly Payment Alberta Blue Cross Non-group Coverage Section A Plan

REGISTRATION FOR PREAUTHORIZED MONTHLY PAYMENT Alberta Blue Cross Non-Group Coverage SECTION A PLAN MEMBER S PERSONAL INFORMATION LAST NAME PLAN MEMBER S PERSONAL HEALTH NUMBER (PHN) FIRST NAME MAILING.

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Forms to apply, change or update account information for AHCIP and Alberta Blue Cross, or request a Statement of Benefits Paid. On this page: Apply for AHCIP....Submit form bring it to a participating registry. send it by mail. fax it to 780-422-0102.

Please complete the Alberta registration form, then print and sign it. The form can then be faxed to 780-498-3549; or scanned and emailed to pamt@ab.bluecross.ca. Please note that it is not necessary to mail the original copy to our office.

All residents of Alberta are eligible to apply unless you are: a new or returning resident from outside Canada, who has not yet lived in Alberta for 12 consecutive months. exempt from paying income tax for religious, charitable or communal reasons.

The Government of Alberta provides seniors with premium-free coverage for prescriptions drugs and other health-related services not covered under the AHCIP. Alberta Blue Cross administers the Coverage for Seniors program and claims.

We're licensed by the Canadian Association of Blue Cross® Plans which means we meet their standards and submit to annual reviews. We also have a working relationship with the American Blue Cross and Blue Shield Association and their member companies.

Government-sponsored supplementary plans cover pre-existing health conditions – no medical review is required. Albertans 65 years of age and over are eligible for the Coverage for Seniors program.

There is no waiting periods for any of our individual plans if you're coming off an Alberta Blue Cross® group benefits plan through your employer within 30 to 60 days.

Contact Alberta Blue Cross® in Edmonton at 780-498-8000 or toll free in other areas at 1-800-661-6995.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232