How does the state health insurance system work?
If you are resident in the Caymans, you must by law have health insurance, from a government approved provider (including the government’s own health insurer). These are licensed and regulated by the Cayman Islands Monetary Authority and the Health Insurance Commission and cover around 94% of Cayman residents. If you are working, your employer must register you with a Standard Health Insurance Contract (SHIC) from the first day of your employment.
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Who is eligible for state healthcare?
Everyone resident in the Caymans will be eligible to sign up with a SHIC but note that this is a private rather than a public health insurance scheme.
How do you apply to join the state health insurance system?
Your employer should sign you up with a SHIC, but check the coverage that any proposed package gives you. You will need to have a medical check and the extent of this will vary depending on the coverage required: a more comprehensive package will need a more extensive medical check, so make sure that you bring your medical records to the Caymans with you. It is also a good idea to ask your employer to seek pre-approval with any insurer if you have a pre-existing health condition.
If you have been with your insurer for 12 months, you should be able to change your coverage with no restrictions, even if you have developed a health issue during this period.
You may also be able to extend your existing coverage in your home nation to cover you while you are in the Caymans, but legally you will still need to be registered with a SHIC.
What is covered by the state health insurance system?
The SHIC system covers:
- GP visits (outpatient coverage tends to be limited, however)
- hospital care, including chemotherapy and radiotherapy
- surgical care
Since this is essentially a private insurance system, the level of coverage will depend on your premium: you may wish to opt for more comprehensive insurance, for instance, which covers prescription charges.
Your doctor or dentist will usually claim costs directly from your insurance company. Payments are based on a government-set Standard Health Insurance Fee (SHIF) schedule, but it is advisable to get a preliminary quote, particularly for extensive treatment, since medical services are not legally obliged to keep within the SHIF guidelines and any additional costs must be borne by the claimant.
Are retirees covered by state medical insurance?
If you are not working, you will need to take out private health insurance during your residence in the Caymans. Most employers will not extend health insurance to retirees. If you fall ill during your stay in the islands, you will need to keep all your receipts for your medical costs and issue them to your own insurer in due course. Check whether your insurer has an agreement with a provider in the Caymans, as this can save time and expense.
You have the option of going through a broker, who will understand the local insurance market.
Are students covered by state medical insurance?
You will need to take out private health insurance if you are studying in the Caymans. Consult your educational provider, such as the University College of the Cayman Islands, to see if they recommend any particular provider.
Will your family be covered by your insurance?
Your dependents (spouse and children) are required by law to have health insurance with a SHIC or with your own international provider. Check with your employer if the package with which they register you covers your dependents. Usually this will be in part, if at all, and you may find yourself having to provide 100% insurance for your family.
Is dental treatment covered by state health insurance?
You can opt for a SHIC which covers dental treatment, or a separate dental plan.
What are the contribution rates for state health insurance?
Your employer must choose the lowest cost SHIC available to their employees and must contribute a minimum of 50% of the premium. This is a legal requirement, but you can try negotiating with them to pay more of your premium. You will need to pay the rest.
It is advisable to check your insurance package and see whether an upgrade is desirable and possible, and how that is to be funded between yourself and your employer. If your employer has over 10 employees, then it may be possible to enroll you in a group insurance plan, which usually has lower premiums.
Why buy private health insurance?
As noted above, the SHIC is a private insurance plan system. You may prefer to take out coverage with an international provider if you plan to move elsewhere within a short period of time.
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What is covered by private health insurance?
See above for coverage: as discussed, this will depend on your insurance package.
How much does private health insurance cost?
For a basic SHIC plan (for example, one without dental and vision coverage), you will be looking at around CI$167 (US$200) per month. Coverage which includes more extensive outpatient benefits will usually cost 20-30% more.
More extensive plans, including for instance visits to your GP or a specialist, plus dental, vision and prescription coverage is likely to cost up to CI$500-$900 (US$600 – 1079) per month. You could be looking in the region of CI$450-$850 (US$539 – 1019) without dental and vision coverage. These rates will approximately be doubled for a couple and tripled for family coverage.
Which companies offer private health insurance?
There are a variety of companies which offer SHICs, including the government contractor CINICO which offers health insurance coverage to civil servants (employees and pensioners), seafarers and veterans, and other residents of the Cayman Islands. Insurers include:
- BAF Insurance Ltd
- BritCay
- Cayman First Insurance Company Ltd
- CINICO
- Generali at HIS Ltd
You may also wish to take out private coverage with an international provider and keep your SHIC cover to a minimum, in which case you will find that the following cover the Caymans:
- AETNA
- BUPA
- Cigna
Glossary of health insurance terms
Health Insurance Commission (HIC) - the regulatory healthcare authority
English is the official language of the Caymans, so you should have no difficulties with the language if you are a native speaker.