Covid-19 Vaccine Coverage in Alberta - What Employers Need to Know

Fall is definitely here - pumpkin spice lattes are on sale, the colder weather is starting to set in, and everyone has that little hint of a cough. Since 2019, coughs have taken on a whole new meaning for the world and not only are people preparing for cold and flu season, they’re thinking about how to protect themselves against Covid-19. 

Alberta has recently changed Covid-19 vaccine coverage, and it’s no longer free for all residents. Some residents will still be eligible, but for many, there will now be an out-of-pocket expense - which may come as a surprise. Employers need to understand what this means for their group benefits plans and how they can support employees as winter approaches.

What’s Changing with Covid-19 Vaccines in Alberta

Covid vaccines are no longer universally covered by the province. Only the highest risk groups will be eligible for vaccines free of charge, from October 1, 2025. That includes:

• Health care workers

• Residents of continuing care homes and seniors' supportive living accommodations

• Home care clients

• Individuals experiencing houselessness

• Individuals aged 65 and older receiving the Alberta Seniors Benefit

• Individuals aged 6 months and older with underlying medical conditions or compromised immune systems.

You may also qualify for free vaccine coverage if you have an eligible medical condition. Vaccines covered by the province are available exclusively through public health clinics. 

After October 20, 2025, the vaccine will be available to all other Albertans 6 months or older - but there will be a cost. If you don’t qualify for vaccine coverage by the province, there are two ways for you to access vaccines in Alberta:

• The Alberta government supply is available through Alberta Health Services (AHS) public health clinics. These are available at a cost of $100 per dose.

• Community pharmacies are also offering Covid-19 vaccines - to Albertans 12 years and older - but these are more expensive, approximately $135-$140 per dose plus an injection fee.

Do Your Employee Benefits Cover Vaccines?

The added cost for employees and their families to get the Covid-19 vaccine - or the additional cost of time lost due to illness if someone isn’t properly protected - can be a worry for both employees and employers.  

It’s important for employers to understand if they have vaccine coverage - because while some plans include it; others do not. Employers can check their coverage by:

• Reviewing your benefits booklet.

• Using the online drug lookup tool in the benefits portal.

• Contacting Shannon for support.

If vaccines aren’t covered, this benefit can be added. 

Employees should remember to check how much drug coverage they have left before getting their vaccine. Many plans have annual vaccine limits.

Submitting Vaccine Claims

If you’ve paid out of pocket for your vaccine and your benefits plan includes coverage, you can submit your receipt for reimbursement. This can be done with a receipt from either AHS or from a community pharmacy - but keep in mind, pharmacy injection fees are not eligible for reimbursement. 

If you’ve attended an Alberta Health public health clinic:

• You'll be mailed an invoice after your public health vaccine appointment.

• Once you’ve paid the invoice, call AHS to request a receipt (Toll free: 1-855-919-6097).

• Your receipt will be mailed to you. This may take longer than usual due to Canada Post strike action. 

• Once you’ve received your receipt, submit the claim online through the benefit portal/app.

  
  

Employees must wait to receive a receipt by mail from AHS before submitting a claim. Top tip for employers: remind your employees about the receipt process so they don’t miss the reimbursement window.

If you’ve attended a community pharmacy, the cost can be direct billed by the pharmacy. However, if you’ve paid out of pocket at the pharmacy, make sure your receipt includes the following information so that you’ll be eligible for reimbursement: 

• First and last name of the person receiving the vaccination

• Date of service

• Description of the service or Drug Identification Number (DIN)

• Quantity

• Name of the community pharmacy

• Amount charged, which has been marked as paid in full (zero balance owing).

Why Employers Should Act Now

Keeping your employees and their families healthy is important all year round, but never is this as front of mind for everyone than when the colder weather starts to creep in. Now that costs have shifted and changing Covid-19 vaccine eligibility is in the news, employees will be asking questions. Adding or confirming vaccine coverage shows your support for employee health and wellbeing, and proactive communication can prevent confusion and frustration.

I encourage all employers to review their current employee benefits and if vaccine coverage is not already part of your plan, consider whether adding it is right for your business. If you’re not sure whether your plan covers vaccines, or if you’d like to explore adding this coverage, reach out to me and we can walk through your options together.