Jamaica has a two-tier health insurance system, but healthcare in Jamaica is not of a high standard, and you may wish to consider a private policy with a medical evacuation clause, as more serious conditions may need to be treated off the island.

Jamaica has a two-tier system of health insurance, with both public and private cover. However, it is in the process of overhauling the national health insurance scheme, run by the National Health Fund (NHF), an agency of the Ministry of Health (established in 2003 by the National Health Fund Act) and is aiming to provide the Jamaican population with universal coverage.

Jamaica is also pouring money into hospitals and other medical infrastructures, in line with WHO guidelines. Thus the standard of public healthcare in Jamaica can be anticipated to undergo improvement, but at present you can expect to find advanced facilities only in Kingston and Montego Bay and these may not be up to the standard that you would expect in, for instance, the US.

The NHF Card Programme provides subsidies to every person living in Jamaica at any age for the treatment of 17 chronic illnesses including epilepsy, asthma, arthritis, diabetes and depression, and will also allow you to access prescriptions. It works on a co-payment system, in which the NHF pays the bulk of the cost and you must cover the rest.

State healthcare is available to all legal citizens and residents of Jamaica.

Your employer should register you with the national scheme or a private provider, depending on your employment package.

If you wish to sign up with the NHF yourself, you will need to follow this procedure:

• collect an NHF Application Form from your doctor, hospital, health clinic, pharmacy, NHF Head Office or NHF Helpdesk locations
• take it to your doctor, who will fill in your medical history
• the doctor must sign the card, including their registration number
• complete the relevant sections of the card – name address, date of birth, gender and your Tax Registration Number (TRN). If you do not have a TRN card, apply to your nearest Tax Office
• ensure that you copy the number correctly on your application or attach a photocopy to the completed application form, and mail or take them to the NHF office
• an adult or a legal guardian must sign the application card for children under the age of 18

The state insurance system covers:

• primary treatment
• hospital treatment
• treatment for 17 chronic diseases

Jamaica has a JADEP plan for older residents, which covers treatment for chronic conditions such as cardiac disease, glaucoma, and hypertension. If you are planning to retire to Jamaica, however, it is advisable to consider a private health insurance plan, due to the limitations of the public healthcare system.

Some local private providers will not insure you if you are over 65, unless you have previously enrolled with them below that age, so it is important to check any potential policy carefully or discuss it with your broker.

It is advisable that if you are coming to the island to study, you consider taking out some form of private insurance cover, either with an international provider or a local Jamaican insurer. Consult your educational institution for their recommendations.

It is advisable to sign your dependents up with a private health insurance provider.

Public dental care is limited and there is a significant shortage overall of dentists in Jamaica. You may wish to consider a private dental plan which includes the option of being treated in the USA.

Employees and self-employed persons contribute into national insurance, which includes health insurance, at a rate of 2.75% on a maximum remuneration / earnings of JMD 1.5 million (around US$7K – 10K). Employers also contribute at a rate of 2.75% on a maximum remuneration of JMD 1.5 million. If you are employed, your contributions will come directly out of your monthly salary via payroll.

NIS contributions are tax deductible and Jamaica currently has the lowest contribution rate in the Caribbean.

Many expats in Jamaica choose to take out private cover to avoid long waiting times, medication shortages and limitations of the Jamaican public healthcare system, which is significantly overstretched and lacking in essentials. Patients in the public sector have, for example, found themselves having to purchase critical pieces of equipment for themselves before their operations can go ahead.

In addition, out of pocket payments in the private sector can be expensive, with quotes of between $3,500 – $4,500 to see a private doctor in Kingston. Medical centres may also require cash payments upfront for any treatment.

Private health insurance will cover primary and hospital care, plus specialist visits and elective procedures such as cosmetic surgery or advanced dental treatment.

It is also advisable to consider an insurance policy which covers medical evacuation in case of complex conditions which may need to be treated in the States. Many expats choose to undertake medical treatment in nearby Florida, for example.

As so many variables have an effect on the cost of international private medical insurance it becomes very difficult to give accurate estimates without knowing the full details of the coverage required. However, as a very rough guide, using a standard profile of a 40 year old British male with no deductibles, no co-insurance, a middle tier plan/product, all modules included and worldwide coverage excluding the US, a ballpark price of around £4,000/$5,000 might be expected.

The larger international companies cover Jamaica, including:

• AXA
• Cigna
• Foyer Global Health
• Pacific Prime

The official language of Jamaica is English and you should have few problems communicating with medical professionals if you are a native speaker.