Mar 6, 2026
Jack MacTavish and his family went through the ringer last Christmas.
The 92-year-old was transferred to Foothills Medical Centre in Calgary, Alberta, to be treated for multiple issues, including heart failure, a urinary tract infection and a bout with pneumonia, CBC News reported (1).
Advertisement
The icing on top of the cake of medical issues Jack endured? An unexpected bill.
After he had spent weeks in the hospital, hospital staff told Jack’s daughter, Joan MacTavish, he would need to be transferred to a “supportive living facility,” and that the family would be on the hook for about $70 per day while Jack waited for a spot at a facility to become available.
"I said I did not understand why we were paying a fee at all because he was in the hospital being looked after by doctors and nurses, and as far as I knew that was something that would be covered under Alberta health care,” Joan told the news outlet.
The ALC Accommodation Charge
The reason the MacTavishes were charged an additional fee is due to a co-payment fee the Alberta government put in place back in 2015 — the Alternative Level of Care (ALC) Accommodation Charge.
The ALC Charge is invoiced to patients in hospitals that no longer require its services but are waiting to be transferred to a suitable care facility (2). According to the Alberta government, the $69.20 fee is the amount an individual would be charged to stay in a shared room at a continuing care home. This fee was implemented to help “offset accommodation costs” including meals and maintenance.
According to research from MEI (formerly the Montreal Economic Institute), a patient requiring an alternative level of care costs the country’s health systems around $730 to $1,200 per day (3). The policy think tank also notes that annually, an average of 4,760 Albertans were in hospital beds while waiting for spots to open up in continuing care facilities.
Individuals who may face financial hardship from the charge can seek “possible government support and other benefits,” according to the Alberta legislature — the ALC charge does not apply if the transfer is for end-of-life care, however.
Must Read
- Stop the leak: 5 costs Canadians (still) overpay for every single month. How many are sabotaging your 2026 budget?
- What's your worth? Here are the 3 net worth milestones that change everything for Canadians (and what they say about you)
- Dave Ramsey says this 7-step plan ‘works every single time’ to kill debt, get rich — and that ‘anyone’ can do it
ALC fee systems draw criticism
Alberta isn’t the only province with an ALC fee for patients waiting in hospitals to be transferred to continuing care facilities.
Advertisement
Ontario has a chronic-care co payment for ALC patients that meet the proper criteria (4), charging $68.56 per day. Ontario also charges a $400 fee if an ALC hospital patient refuses to take the first available community location (5).
These policies have drawn criticism over the years. University of British Columbia health policy expert Jason Sutherland told CBC that he believes Alberta’s ALC fee is not just designed to recoup costs, but also to disincentivize patients from staying in hospital too long unnecessarily — a method that he thinks doesn’t work.
“Charging patients, in my mind, is not the best tool. In my mind, the best tool would be to start to resource community care better so that these patients want to move out of the hospital more quickly,” Sutherland said.
Rosalie Wyonch from the C.D. Howe Institute (6) notes that the issue of ALC patients bottlenecking the health system is multi-layered, and provinces have a responsibility to enact supportive policy — especially when it comes to seniors.
Advertisement
“Increasing the number of seniors’ care spaces, the scope and provision of home care, primary care access and ensuring that necessary support services are accessible and affordable would alleviate the strain on hospitals and allow for more rapid discharge of patients to alternate levels of care,” she writes.
In addition to the ALC fee, Alberta specifically has a number of other hospital-related costs not covered under the Alberta Health Care Insurance Plan (7), which require upfront payment, such as:
- Ambulance services (except for transfers between facilities)
- Experimental/clinical procedures
- Non-medically necessary private or semi-private hospital rooms
- Hearing aids, prosthetics, mobility devices
How to prepare for unexpected health costs
Unexpected bills are a part of life, but they can strike with greater intensity when you’re on the tail end of a health scare. Here are some ways to prepare for financial hits when you’re most vulnerable.
- Set up an emergency fund. Creating an emergency fund for all unexpected expenses is the easiest way to prepare for the future. Aim to save for around three to six months worth of expenses to give you a proper cushion. Keeping these savings entirely liquid is a good idea generally, but investing in more conservative, liquid investments such as bond ETFs doesn’t hurt either.
- Review your benefits. Signing up for employee benefits can be a major relief when it comes to emergency medical situations. But like any type of contingency coverage, the monthly premiums can be tough to swallow. Make sure the costs are worth it in the long run.
- Know what is and isn’t covered. Financially preparing for unseen medical payments also means knowing all your options. Research what your province does and does not cover for medical procedures/hospital services so you know what you’re saving for.
Read more: The ultra-rich are bailing on volatile stocks right now — these 4 shockproof assets are their new safe havens
Bottom line
Stories like Jack MacTavish’s shine a light on a tough reality: Even in Canada’s publicly funded system, unexpected healthcare costs can show up when families are already stretched thin. Looking into long-term care and supportive living options long before a hospital stay gives families time to compare costs, waitlists, preferences and line up finances and benefits.
Then, if a loved one’s health takes a sudden turn, decisions are planned rather than rushed — and families can focus more on care and less on scrambling to cover costs.
Article sources
We rely only on vetted sources and credible third-party reporting. For details, see our editorial ethics and guidelines.
CBC (1); Alberta.ca (2, 7); MEI (3); Ontario.ca (4); Fasken (5); C.D. Howe Institute (6)
You May Also Like
- Here’s how to retire in 10 short years no matter where you live in Canada — even if you’re starting with $0 savings
- If you’re still feeling the pinch this month — don’t panic. Here are 5 easy ways to fix your finances without a total overhaul
- How Warren Buffett’s simple buy-and-hold real estate approach offers a lesson for Canadian homeowners and long-term investors
- Approaching retirement with no savings? Don’t panic, you're not alone. Here are easy ways you can catch up (and fast)
Brett Surbey is a corporate paralegal with KMSC Law LLP and freelance writer who has written for Yahoo Finance Canada, Success Magazine, Publishers Weekly, U.S. News & World Report, Forbes Advisor and multiple academic journals. He and his family live in northern Alberta, Canada.
