Some people laminate them, others take care pulling the frayed piece of paper out of their wallet.
Alberta's health care card is an anachronism, an object of wonder for people who move here from other parts of Canada.
Other provinces have plastic cards with expiry dates. Cards in Quebec, Ontario and B.C. even have photos. But Alberta mysteriously keeps issuing the flimsy rectangular paper cards, year after year.
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However, that era is soon coming to an end, thanks to Alberta Auditor General Merwan Saher.
In his October 2015 report, Saher said the lack of expiry dates on Alberta health cards leave them open to abuse, meaning the province could be paying for health care of ineligible recipients.
Not requiring people to renew the cards means the province may not be properly tracking people who leave the province.
In response to Saher's concerns, Alberta Health officials are examining a number of options for new cards, which most likely will not be made of paper.
Although the department has no deadline for making a decision, Alberta Health spokesman Cam Traynor said the issues flagged by the auditor general are "absolutely something we're considering very seriously and taking seriously."
"It's going to take some time to look carefully at those recommendations and making sure that the health cards meet the functions that they're intended to do in terms of identification, ensuring people are eligible for health care coverage in the province but also making sure that they're using the most current technology to prevent fraud," Traynor said.
Alberta health care cards have been issued in paper since they were first introduced in 1969. The government kept the paper format when they were switched from family to individual cards in the mid-1990s.
Issue studied in 2008
Alberta relies on migration reports issued by most Canadian provinces and territories for information on who is no longer eligible for health coverage in this province.
The auditor general noted this is not a reliable system. One province doesn't provide migration reports and there is no way for Alberta to check if people move outside Canada.
A renewal process isn't the only change under consideration. Alberta Health is looking at a software system that would alert provinces and territories when a person moves within Canada.
Alberta Liberal Leader David Swann, a medical doctor, thinks the auditor general was right to suggest the system needs more rigour. He also thinks the cards could have more information on them, like photographs.
"I think it's appropriate given the importance of health care, the cost of health care, the accountability needed on both the government's side and the patient's side to have all that information on a card."
However, not everyone feels the government should push ahead. Trevor Zimmerman, with Friends of Medicare, says putting expiry dates on cards could create problems when people who are homeless attempt to reapply.
"It could lead to confusion as to whether people have access," he said. "And the auditor general was not able to provide how information as to how much savings we could realize by adding expiry dates to our card.
"So without that information it would be a good idea to hold off moving in that direction with the possible negative consequences."
The Alberta government looked at making changes to the cards in 2008. A study concluded that sticking with the paper cards was the best option at that point.
Traynor isn't sure why that decision was made but thinks cost may have been an issue. He says that study is being used in the current decision-making process.