When something serious happens with their health, many Ukrainians who have just arrived in Canada may be afraid to call 911, unsure if they can afford to call an ambulance without local insurance or an Alberta Health Card. Fear of large bills that may arrive in the mail a few weeks later causes some people to hesitate even in critical situations. This article explains in detail what actually happens when you call an ambulance in Edmonton without insurance, how much it costs, who is exempt from paying, what options exist to cover the costs, and what to do if you receive a bill you cannot pay. The most important thing to understand is that in a real emergency, an ambulance will come to you regardless of whether you have insurance or not.
Right to emergency care: an ambulance will always come
The first and most important rule in Canada: in a real medical emergency, when your life or health is at risk, an ambulance will always come, regardless of whether you have insurance, an Alberta Health Card, immigration status, or money. When you call 911 and the dispatcher determines that the situation is urgent, they will immediately send an ambulance to you. The paramedics who arrive will not ask about your insurance before providing assistance. Their job is to stabilize your condition, provide the necessary treatment on site, and, if necessary, transport you to the hospital.
Alberta's emergency medical services system is designed so that no one is left without help because of a lack of money or documentation. Alberta Health Services (AHS), which is responsible for emergency medical services (EMS), handles more than 670,000 calls each year, using more than 930 ambulances and more than 5,000 paramedics across the province. These services operate 24 hours a day, 7 days a week, 365 days a year.
Paramedics are legally and ethically obligated to provide medical assistance to anyone in need, regardless of their ability to pay. Payment issues are only considered after the person has received the necessary care. No one will be denied treatment due to a lack of insurance.
How much does ambulance service cost in Alberta
Although an ambulance will always respond, it is important to understand that ambulance services in Canada are not free for patients. Unlike doctor's visits and hospital procedures, which are covered by the Alberta Health Care Insurance Plan (AHCIP), ambulance services are not an insured service under the Canada Health Act. This means that your provincial health card does not automatically cover the cost of an ambulance.
As of 2025, ground ambulance rates in Alberta are standardized for all residents of the province, regardless of where they live. The provincial rate has two categories:
$250 — if the ambulance arrived, the paramedics examined you, provided assistance on site, but did not transport you to the hospital.
$385 — if the ambulance arrived and transported you to the hospital.
For non-residents of Alberta (people who do not have an Alberta Health Card or who live in another province or country), an additional fee of $200 is added, regardless of whether transportation was provided or not. This means that a non-resident may pay $450 without transportation or $585 with transportation.
It is important to understand that these amounts are only a small portion of the actual cost of ambulance services. The Alberta government subsidizes a large portion of the cost of emergency medical services, so patients pay only a nominal fee. The total cost of an ambulance call can be over a thousand dollars, but the province covers most of it.
Until 2015, Alberta also had additional fees for mileage (distance traveled) and level of service (basic or advanced life support), but these fees were eliminated to simplify the system.
Who is exempt from paying for ambulance services
While most Albertans receive an ambulance bill, there are a few categories of people who are completely exempt from paying.
Seniors (65 years of age and older) who are registered in the Coverage for Seniors program do not receive an ambulance bill. The Alberta government covers the full cost of ambulances for this group. This is one of the benefits of the program for seniors, which also covers medications and other medical services.
First Nations people are also exempt from paying for ambulance services. Health Canada (the federal health ministry) pays the user fee for emergency medical services for First Nations people.
Albertans who receive health benefits through the Income Support, Adult Health Benefits, or Alberta Child Health Benefits programs are also exempt from ambulance fees. If you receive social assistance or have a low income and are registered in one of these programs, the cost of ambulance services is automatically covered.
Alberta Adult Health Benefit is a program that covers medical services, including ambulance services, for low-income households. To be eligible for this program, you must be pregnant, have high ongoing medication costs, or be leaving Income Support or AISH (Assured Income for the Severely Handicapped) due to an increase in employment income. This program covers dental care, prescription drugs, eyeglasses, diabetic supplies, emergency ambulance services, and some non-prescription medications.
Albertans with private insurance, such as the Non-Group Coverage Plan from Alberta Blue Cross or other supplemental health plans, may also avoid ambulance fees if their insurance covers this service. Many employers provide group health plans to their employees that cover ambulance services. If you have this type of insurance, the ambulance service will usually bill your insurance company directly.
People with no address and no income may also have their ambulance fees waived. Alberta Health Services has a policy that if a patient has no permanent address, no income, and payment cannot reasonably be secured, AHS will waive the fee and cover the cost itself. This policy is designed to protect the most vulnerable people, including those without a permanent residence.
Inter-hospital transfers also do not result in a bill for the patient. If you are transported by ground or air ambulance from one approved medical facility to another (for example, from a local hospital to a specialized medical center), you will not receive a bill for this transport. It is considered part of your hospital treatment, not a separate ambulance service.
What happens to Ukrainian evacuees
For Ukrainians who came to Alberta as evacuees, the ambulance situation depends on when you arrived and whether you currently have the Alberta Health Care Insurance Plan.
From April 2022 to March 31, 2025, Ukrainian evacuees received full medical coverage through the Ukrainian Evacuee Temporary Health Benefits Program (UETHBP). This program covered hospital stays, doctor visits, lab tests, X-rays, prescription drugs, dental care, eyeglasses, and emergency care without premiums. However, this program ended on March 31, 2025.
Most Ukrainian evacuees who were registered with UETHBP transitioned to the standard Alberta Health Care Insurance Plan (AHCIP) by the end of March 2025. AHCIP covers basic medical services—doctors, hospitals, lab tests—but does not cover ambulance services, prescription drugs, dental care, or eyeglasses.
This means that if you are a Ukrainian evacuee and currently have an Alberta Health Card (with a Personal Health Number, PHN), you will still be billed for ambulance services unless you have additional private insurance or are registered in a low-income program.
If you have received an ambulance bill but believe you were covered through the Ukrainian Evacuee program, or if you have questions about payment, please contact AHS Finance at 1-855-919-6097. Representatives can explain your situation, verify your coverage, and help with any billing issues.
For Ukrainian evacuees who do not have additional insurance, there are several options:
Non-Group Coverage Plan from Alberta Blue Cross is a program available to Albertans under the age of 65 who do not have group insurance from their employer and do not qualify for low-income programs. This program covers emergency care, prescription drugs, dental, eyeglasses, and other services. The monthly fee is approximately $118 for two adults, billed quarterly. There is usually a waiting period (coverage begins on the first day of the fourth month after application), but Ukrainian evacuees who applied before April 30, 2025, could switch to Non-Group Coverage without a waiting period, with coverage beginning on April 1, 2025.
Coverage for Seniors — For Ukrainian evacuees aged 65 and older who were registered with AHCIP before March 31, 2025, the province automatically enrolled them in the Coverage for Seniors program starting April 1, 2025. This program is free and covers ambulance services, prescription drugs, and other medical services.
Can you refuse an ambulance and not pay
One of the most common questions is what happens if someone else called an ambulance for you, or if you refuse treatment or transport after the ambulance has arrived.
If someone called 911 for you, but when the ambulance arrived, you were already feeling better and decided you didn't need help, you have the right to refuse treatment. Paramedics cannot force you to accept help or go with them to the hospital if you are competent, conscious, and able to make decisions for yourself.
However, it is important to understand a few nuances. If paramedics have already begun to examine you, measure your vital signs (blood pressure, pulse, oxygen saturation), or provided any treatment (for example, bandaged a wound, gave oxygen, gave an injection), you may be billed even if you refused transport to the hospital. In this case, you will be charged $250 for “no transport” — for the ambulance arriving, examining you, and providing assistance, but not transporting you to the hospital.
If you completely refuse any assistance — do not allow paramedics to examine you, do not give them your personal information, and clearly state that you refuse all services — theoretically, you should not receive a bill. However, paramedics usually ask you to sign a refusal of care form (refusal of care or AMA — against medical advice), which documents that you understand the risks of refusal and accept responsibility. This form may ask for your name and date of birth, which may result in a bill even if you did not sign anything.
It is important not to confuse this with the Good Samaritan Law. This law protects people who provide assistance in an emergency from civil lawsuits for damages that may have resulted from their intervention. However, this law does not protect you from government fees or ambulance bills. If you called 911 for someone else, you will not receive a bill—the bill is issued to the patient who was examined or transported by the ambulance, not to the person who made the call.
If the ambulance has already arrived and the paramedics believe that your condition is serious and you need help, but you still refuse, they will contact their medical director (medical control) for consultation. If there is a suspicion that you are unable to make rational decisions due to head injury, intoxication, mental illness, or another condition that affects your consciousness, paramedics may transport you to the hospital without your consent, and you will receive a bill. This is done to protect your life.
What to do if you receive an ambulance bill and cannot pay
If you receive an ambulance bill and cannot pay it, do not ignore it. Alberta Health Services offers several options to help patients with financial difficulties.
The first thing you should do is contact the AHS Finance Department at 1-855-919-6097 or send an email to [email protected]. Representatives can help you set up a payment plan, with some options starting at $10 per month. Interest rates on payment plans are very minimal.
If you have a very low income or no income at all and are homeless, explain your situation to AHS representatives. As mentioned earlier, AHS has a policy of writing off payments for people without an address or income. They can review your situation and, if you qualify, write off the bill entirely.
If you have private insurance (for example, through your employer or Alberta Blue Cross), check to see if your plan covers emergency care. If so, contact your insurance company and provide them with the bill from AHS. Many insurance companies have direct agreements with AHS and can pay the bill directly. Some insurance companies will reimburse you after you have paid the bill, so keep your receipt.
If you recently received your Alberta Health Card and believe you should have had coverage during your ambulance call but did not provide your Personal Health Number (PHN) to the paramedics on site, explain this to the AHS finance department. They can check your coverage and, if you were eligible for a fee waiver (e.g., through the Seniors, First Nations, or Adult Health Benefits programs), they can cancel the bill.
If you paid for the ambulance out of pocket and later found out you were eligible for coverage, you can apply for a refund. Contact the AHS finance department with your receipt and your Alberta health card, and they can review your case.
Finally, don't forget that ambulance costs can be claimed on your tax return as medical expenses. When filing your 2025 taxes, include your ambulance bill under medical expenses — this may reduce your tax liability or increase your tax refund.
Air ambulance
In addition to ground ambulances, Alberta Health Services also provides air ambulance services, including both helicopters and fixed-wing aircraft. Air ambulances are used to transport patients over long distances, from remote areas, or when speed is critical to survival.
Air ambulances are arranged through the AHS EMS Central Communications Centre in Edmonton. AHS contracts with 11 fixed-wing aircraft to provide 24-hour service across the province, as well as three helicopter providers.
Air ambulances are significantly more expensive than ground ambulances, but for Albertans with coverage, the rates are subsidized in the same way as ground ambulances. If you have an Alberta Health Card and meet the criteria for air evacuation (for example, you are in critical condition in a remote area where ground ambulances cannot reach you in time), you pay the same rates as for ground ambulances, or nothing at all if you are exempt.
However, for non-residents of Alberta or people without coverage, the cost of air ambulance can be very high — thousands of dollars per hour for a helicopter and hundreds of dollars per kilometer for a plane. If you are traveling outside of Alberta or Canada, it is highly recommended that you have travel medical insurance that covers air evacuation.
STARS Air Ambulance is a non-profit air ambulance service that operates in Alberta, Saskatchewan, and Manitoba. Unlike AHS, STARS does not bill patients at all. STARS is funded solely through donations, lotteries, calendars, and other fundraising efforts. If STARS transports you, you will not receive a bill, regardless of your insurance status. STARS can only be called through local emergency services or hospitals, not directly by the public.
Alternatives to Ambulance Services
Since the cost of ambulance services can be significant for people without insurance, it is important to know when an ambulance is truly necessary and when there are alternatives.
If you or someone nearby is experiencing a true medical emergency—chest pain, stroke, difficulty breathing, severe bleeding, loss of consciousness, severe trauma—call 911 immediately, without thinking about the cost. In these situations, every minute counts, and an ambulance can save lives.
However, for non-emergencies, when the condition is serious but not life-threatening, there are other options:
Health Link 811 — call this toll-free number to speak with a registered nurse who will assess your symptoms and advise you whether you need to go to the emergency room, visit a walk-in clinic or urgent care center, or stay at home. If the nurse thinks you need an ambulance, they will strongly advise you to call 911, and this will be documented, which may help with insurance coverage later.
Taxi, Uber, or ride with a friend — If your condition is not an emergency and you are able to sit and travel safely in regular transportation, a ride to the hospital by taxi, Uber, or with a friend can be much cheaper than an ambulance. Many people in Edmonton are now choosing this option to avoid an ambulance bill, especially if they do not have insurance.
Urgent care or walk-in clinics — for conditions that require immediate attention but are not life-threatening (e.g., minor injuries, infections requiring antibiotics, minor fractures without displacement), visiting an urgent care or walk-in clinic may be a better option than the emergency room.
However, always remember: if there is any doubt about the severity of the condition, it is better to err on the side of caution and call 911. Life and health are always more important than money, and the system is designed to protect you in a critical moment.
Conclusion
Yes, you can call an ambulance in Edmonton without insurance, and an ambulance will always come in a real emergency. Paramedics will not refuse to help you because you don't have an Alberta Health Card, insurance, or money. The emergency medical care system in Canada is designed to protect life as a first priority, and payment issues are dealt with later.
However, it is important to understand that after receiving assistance, you will most likely receive a bill — $250 if you were not transported, $385 if you were transported, plus an additional $200 for non-residents of Alberta. If you do not have insurance and cannot pay this bill, contact the AHS finance department at 1-855-919-6097. They can set up a payment plan starting at $10 per month, waive the bill for people without income or an address, or help you register for low-income programs that cover ambulance services.
For Ukrainian evacuees who have transitioned from the Ukrainian Evacuee Temporary Health Benefits Program to the Alberta Health Care Insurance Plan, it is important to consider supplemental insurance, such as Non-Group Coverage from Alberta Blue Cross, which covers ambulance, medication, dental, and eyeglasses. If you have questions about your bill or coverage, always call AHS—they are there to help.
The most important rule: in a real emergency, never hesitate to call 911 because you are concerned about the cost. Life has no price, and the system is designed to save you in a critical moment, regardless of your ability to pay.