Health insurance is a type of insurance coverage that covers the cost of an insured individual’s medical and surgical expenses. In Cayman, this is categorised into one of two types: private or public.
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Every resident of the Cayman Islands is required, by law, to have at minimum health insurance which covers basic medical expenses.
Given the wide variety of services available, Cayman can provide quality care for most medical situations. However, healthcare and medications are costly, so it is essential that you either have a health insurance policy that covers travel if you are visiting or health insurance coverage if you are a resident. With local life expectancy continuing to climb, child vaccination rates hovering over 90% (except for COVID-19), and 93-94% of the population covered by health insurance, the partnership of public, private and non-profit entities in the field of healthcare continues to be of benefit to all groups within the community.
Most medical and some dental practitioners accept local insurance ‘on assignment’ provided that the insurance company guarantees payment and the deductible, if applicable, has been met. This means that the doctor or dentist will claim work done directly from the insurance company on your behalf. Anything not paid by your insurance company is your responsibility. Medical providers are not required to charge within the Standard Health Insurance Fees or SHIF, and balances above the SHIF are the patient’s responsibility. For substantial medical services, it is not unreasonable to ask for a written quote and request that it include a ‘predetermination of benefits and proposed costs’ in addition to the ‘pre-approval of medical necessity’.
Most international health insurance providers are not accepted in Cayman. If a retiree or visitor to Cayman requires medical assistance on-Island, they will usually pay upfront for services, keep all receipts and submit a claim once they return to their home country. The receipts will usually need to be fully itemised with diagnosis information and include the currency used and international disease codes. If you are a visitor, you should request that a claim form be completed using Cayman’s standard claim form. It is advised that you call your insurance company or review your policy before travelling to Cayman to verify how your benefits will work overseas. You may also wish to check if your insurance network extends to any local providers, as some insurance companies have already set up a relationship with local providers, which can save you out-of-pocket costs. However, it is not mandatory for medical facilities to accept overseas insurance. Residents who will have relatives visiting are recommended to inquire about their visitors’ insurance too. If your visitors’ insurance will not cover them whilst in Cayman, they should be encouraged to seek a travel policy to protect them (and to protect you from being asked to sign for financial responsibility if they become ill or injured).
For detailed information on understanding health insurance for kids – covering everything from having a baby all the way to what happens to insurance when a child leaves for college abroad – read the Health Insurance article on the Cayman Parent website.
It is mandatory for every resident in the Cayman Islands to have the minimum health insurance, therefore it is essential for you to know the laws that must be followed by you and your employer.Read More
Plans vary from the basic SHIC to very comprehensive major medical world-class plans. Shop around to find the health insurance coverage that perfectly suits your needs and budget.
Health insurance is mandatory for all residents in the Cayman Islands and must be obtained through one of the approved insurance providers listed here, which includes the Government owned CINICO.
The advantage of working through an insurance broker is that they understand the products and market, and can often save you both time and money by comparing costs, terms and coverage options for you.