A northern Alberta senior thought she was going into cardiac arrest. The medevac cost her $29,000

There is no grocery store, post office or doctor's office in remote Fitzgerald, Alta.

The northern community is located more than 700 kilometers northeast of Edmonton on the Slave River, near Wood Buffalo National Park. The only year-round road from Fitzgerald connects it to the Northwest Territories.

The nearest town with amenities and health care is Fort Smith, located just across the border in NWT, about 15 miles to the northwest.

Beverly Tupper, a 78-year-old Fitzgerald resident, recently learned that while an Alberta health care card covers doctor visits in NWT, it doesn't cover everything.

In September 2023, Tupper went to the health center in Fort Smith with an atrial flutter. Her heart was beating at more than 200 beats per minute.

As a former public nurse, she knew this could ultimately lead to cardiac arrest.

“It was really scary,” said Tupper, who was a guest on CBC's Radioactive Healthcare audit earlier this month.

She was sent to Edmonton on a medical flight – a trip that would cost her $29,000.

Due to wildfires, many northern communities were evacuated just as Tupper was receiving medical attention, including Fitzgerald.

“There were no doctors in Fort Smith because they were all evacuated,” she said.

Not covered

A statement from the office of Alberta Health Minister Adriana LaGrange said that while Alberta has reciprocal billing agreements with other provinces to cover necessary hospital and physician services, ambulances and medevacs from other provinces or territories into Alberta are not covered .

That type of coverage is not a requirement under the Canada Health Act, the statement said. It added that no other province or territory funds air ambulance services across borders.

The province recommends people purchase travel health insurance if they plan to travel outside Alberta.

But that makes no sense for people who have to cross a provincial border to access basic services, Tupper said.

'I don't travel. I just do my daily things, like getting gas and checking the mail.'

Tupper hasn't paid her $29,000 bill. She says she can't afford it.

She has tried to seek help from the Alberta and NWT ministers of health, the federal health minister, her MLA and her MP, but she has been told the medevac law is her responsibility.

She has since investigated whether she can get year-round medical travel insurance.

However, because she is in her late 70s and has a pre-existing health condition, the available plans would cost her $24,000 a year, “which I can't afford,” she said.

Tupper did pay for the additional coverage for a private ambulance, but found out it wouldn't cover her medical bill.

Alberta and NWT should reach an agreement for residents who live near a border and receive health care from another province or territory, she said.

In the past year, 127 people in NWT who were not from the area were billed for needing medical attention. That's a significant increase from 2016, when CBC reported there were 45 such cases.

Tupper received her medical bill from the Northwest Territories Health and Social Services Authority.

In a statement, the authority said that due to the nature of the NWT's geography, when someone has a healthcare emergency it often requires significant resources, such as a fixed-wing aircraft.

In 2023, Alberta provided medical services to 138 people who did not have health care coverage in Alberta.

While the Canada Health Act is intended to ensure that access to publicly funded health care is available to everyone, everywhere, that is not always the case.

“Despite the fact that this principle of accessibility is in place, at times and under certain circumstances it is quite ambitious,” says Lorian Hardcastle, associate professor at the Faculty of Law and Cumming School of Medicine at the University of Calgary.

While much attention has been paid to the challenges hospitals face in urban centers, other issues are being neglected, such as access to health care in rural areas, Hardcastle said.

“I think one thing that can be quite surprising to people when it comes to the Canada Health Act is that it doesn't always cover exactly the same level of health care from province to province,” she said.

Flew to Edmonton

After being transported to the Royal Alexandra Hospital in September 2023, Tupper spent five weeks in the Edmonton area, recovering and receiving treatment for her irregular heartbeat. She was unable to return home due to a massive, out-of-control wildfire.

Six times a week her heart rate rose above 200 beats per minute. When it happened, Tupper went to the emergency room, where wait times could be up to eight hours.

Sometimes she could slow her own heart rate by inserting a syringe into a nerve leading to her heart and “blowing as hard as I could.”

Another trick was to dunk her face in a bowl of ice water.

To correct the atrial flutter, Tupper underwent cardiac ablation treatments in Red Deer. The treatment uses catheters to create small scars in the heart that block faulty signals and restore a typical heartbeat.

Although she has since recovered and remains active in the garden and raising chickens, Tupper says she is reaching an age where her body is starting to break down.

In 2013, she underwent open-heart surgery to remove a tumor. She then tried to get home care, but was unable to get it in her remote northern community.

“I had to learn to take care of myself pretty well.”