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What a Long-Term Care Bed Costs: How BC, Ontario, and Alberta Set the Resident's Share

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In publicly funded long-term care, the province sets what the resident pays. British Columbia charges up to 80% of after-tax income, Ontario charges a daily rate that can be reduced for low income, and Alberta sets a maximum daily accommodation charge. BC and Ontario both start from net income on the Notice of Assessment, which includes OAS and the GIS.

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The resident's share starts from one line on the Notice of Assessment

Line 23600 of a Notice of Assessment shows a person's net income for the year. The Notice of Assessment is the statement the Canada Revenue Agency (CRA) sends after it processes a tax return. British Columbia and Ontario both use this line to work out what a long-term care resident pays.[1][2] Island Health, one of BC's health authorities, asks residents to file their tax return by April 30 each year. It also asks them to consent to the CRA sharing their income information with the Ministry of Health.[3]

The charge is set by the province, not by the care home. Alberta says health care goods and services in its continuing care homes are publicly funded at no cost to residents.[4] The resident's charge covers accommodation. In Ontario, the Ministry of Long-Term Care sets the maximum co-payment each year.[2]

Old Age Security and the GIS are both part of net income

Old Age Security (OAS) is reported on line 11300 of the federal return. The Guaranteed Income Supplement (GIS) is reported on line 14600. Both lines are part of total income.[5] For 2025, a person with net income before adjustments of $93,454 or less claims a matching deduction for the GIS on line 25000.[6] That deduction keeps the GIS from being taxed.

The deduction comes in the step after line 23600, where taxable income is worked out.[5] The GIS is therefore not taxed, but it still counts in the net income that long-term care fees are based on. A resident whose income is mostly OAS and the GIS has that whole amount counted.

British Columbia charges up to 80% of after-tax income

BC's Continuing Care Fees Regulation defines after-tax income as net income from line 23600 minus total income tax from line 43500, with some smaller adjustments, divided by 12.[1] The province uses two formulas for the yearly figure:[7]

The province says the $3,900 deduction, or $325 a month, is set so that most residents keep at least $325 a month.[7] As an illustration, after-tax income of $30,000 a year gives a rate of $2,000 a month. Every rate also falls between a minimum and a maximum.[7] The minimum is the maximum monthly total of OAS and the GIS, minus $325.[1] The regulation sets a starting maximum of $3,198.50 a month and raises it every January 1 in line with the Consumer Price Index.[1]

When spouses share a room and both get the GIS at the married rate, each pays a rate based on their own after-tax income.[7] A resident facing serious financial hardship can apply for a temporary reduction. BC defines hardship as being unable to pay for food, housing, heat, medication, or required health care.[7]

Ontario sets a daily rate and reduces it only for basic rooms

From July 1, 2026, Ontario's maximum co-payment is $70.00 a day for a basic room. That works out to $2,129.17 a month. A semi-private room costs $84.40 a day ($2,567.17 a month), and a private room costs $100.01 a day ($3,041.97 a month).[2] The province says every resident receives the same level of care, whatever the room type.[2]

The Rate Reduction Program lowers the charge for residents of basic rooms who cannot pay the full rate. Regular semi-private and private rooms are not eligible.[2] The reduced monthly rate is net income divided by 12, minus a comfort allowance, which is money the resident keeps for personal needs. The allowance is currently $149 a month.[2] Taxes payable, income from a Registered Disability Savings Plan, and a CPP death benefit can be subtracted from income first. A house the resident owns is not counted.[2]

As an illustration, net income of $24,000 with no tax payable gives $2,000 a month, minus $149, or $1,851. The province says a person with no deductions or exclusions would likely be eligible with income under $27,338.[2] Applications are due within 90 days of admission, and residents re-apply each year between July 1 and September 28.[2]

Alberta sets a maximum daily charge for accommodation

Alberta does not use a percentage of income. The province sets a maximum accommodation charge for type A homes, formerly called nursing homes and auxiliary hospitals, and for type B homes.[4] From August 1, 2026, the maximum is $71.85 a day for a shared room and $83.05 a day for a private room. These amounts rose by 1.8% from the rates set on April 1, 2026.[4] As of January 2026, residents who receive the Alberta Seniors Benefit or AISH keep at least $373 a month after paying the charge.[4]

Fees for full-time care can be claimed as a medical expense

The CRA describes a nursing home as a facility that gives full-time care, including 24-hour nursing care, to people who cannot care for themselves.[8] For full-time care in such a home, the CRA allows the whole amount paid as a medical expense. That includes food, accommodation, nursing care, administration, maintenance, and social activities, but not personal extras such as a hairdresser.[8]

The claim needs either an approved disability tax credit certificate (Form T2201) or a written certificate from a medical practitioner.[8] For 2025, the claim counts only above 3% of net income or $2,834, whichever is less.[8] Our guide to the medical expense tax credit explains how the claim is made. A resident with an approved disability tax credit can claim the disability amount or the full-time care fees, but not both. The one exception allows up to $10,000 of the salaries and wages part of the fees alongside the disability amount.[8]

Notes

  1. Section 5 sets the residential care charge, the starting maximum of $3,198.50 adjusted each January 1, and the minimum based on the maximum OAS and GIS less $325. BC Laws (Province of British Columbia), “Continuing Care Fees Regulation, B.C. Reg. 330/97”, current to 2026-01-13. https://www.bclaws.gov.bc.ca/civix/document/id/complete/statreg/330_97 Accessed .
  2. Co-payment rates are effective July 1, 2026. The Rate Reduction Program year runs from July 1 to June 30. Government of Ontario, “Paying for long-term care”, page last updated 2026-07-10. https://www.ontario.ca/page/paying-long-term-care Accessed .
  3. Island Health, “How fees work”, page last updated 2026-07-22. https://www.islandhealth.ca/services/community-health-services/how-fees-work Accessed .
  4. Government of Alberta, “Continuing care accommodation charges”, page last updated 2026-06-26. https://www.alberta.ca/continuing-care-accommodation-charges Accessed .
  5. Lines 11300 and 14600 appear under Step 2 (total income); line 25000 appears under Step 4 (taxable income), after line 23600. Canada Revenue Agency, “Federal Income Tax and Benefit Information for 2025”, page modified 2026-01-20. https://www.canada.ca/en/revenue-agency/services/forms-publications/tax-packages-years/general-income-tax-benefit-package/5000-g.html Accessed .
  6. Canada Revenue Agency, “Line 14600: Net federal supplements paid”, page modified 2026-01-20. https://www.canada.ca/en/revenue-agency/services/tax/individuals/topics/about-your-tax-return/tax-return/completing-a-tax-return/personal-income/line-14600-net-federal-supplements.html Accessed .
  7. The page explains the formulas and how the minimum and maximum change each year; it does not list the current dollar minimum and maximum. Province of British Columbia, “Long-Term Care Services”, page last updated 2025-01-01. https://www2.gov.bc.ca/gov/content/health/accessing-health-care/home-community-care/care-options-and-cost/long-term-care-services Accessed .
  8. Canada Revenue Agency, “Medical Expenses 2025 (RC4065)”, page modified 2026-01-20. https://www.canada.ca/en/revenue-agency/services/forms-publications/publications/rc4065/medical-expenses.html Accessed .

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Written by OAS Guides, research team,

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