You are here: Homepage > CINICO Plans > Seafarers & Veterans > FAQs
FAQs
- What are the eligibility requirements?
- "Seaman" means a person who resides in the Islands and who:-
- is a member of either, the Veterans’ and Seamens’ Society of Cayman Brac and Little Cayman or of the Cayman Islands Seafarer’s Association or a member of the Cayman Islands Veterans Association; and
- First went to sea before January 1st. 1985 or served in the armed forces before 1973.
- Was a Caymanian (as defined under the immigration Law (2003 Revision) during the period of time when he was at sea, or served in the armed forces.
- Who is eligible as a dependent for my policy?
- A Seaman’s/Veteran’s unemployed spouse or widow, and for local services at the HSA, unmarried children from birth to their 18th. birthday. The dependent children must be primarily dependent upon the covered Seaman/Veteran for support and maintenance. However, a dependent child will continue to be covered after their 18th birthday, provided the child is a full-time student at an accredited school, primarily dependent upon the covered Seaman/Veteran for support and maintenance, is unmarried and under the limiting age of 23. When the child reaches limiting age, coverage will end. If the child does not maintain fulltime attendance or graduates, coverage closes independent of limiting age.
- Can I visit any Doctor or Hospital?
- No, unless you get a Chief Medical Officer (CMO) referral from the Health Services Authority (HSA) which includes the George Town Hospital and Faith Hospital in Cayman Brac.
- How are my services covered if I use an HSA provider?
- All medically necessary services, up to maximum allowable, are covered in full as long as HSA providers perform care.
- What if I go to a non-HAS provider without CMO approval?
- If you elect to see a non-HAS provider, the service will be at your own expense.
- If my HSA provider needs to refer me to a private practice provider within the Cayman Islands, will I be covered?
- Yes, if the Cayman Island’s Chief Medical Officer (CMO) determines it to be medically necessary.
- What do I do in an emergency?
- A medical emergency means a sudden onset of a condition with acute symptoms requiring immediate medical care and includes such conditions as heart attacks, cardiovascular accidents, poisonings, loss of consciousness or respiration, convulsions or other such acute medical conditions. For local emergencies go directly to an HSA facility. For overseas situations, call the Overseas Case Management Co-ordinator phone number on the front of your CINICO member card.
- How are benefits paid if I require emergency treatment while overseas?
- Life-threatening emergencies/sudden and serious onset of illness are considered for payment only when you contact the Case Management Co-ordinator at the phone number listed on the front of your CINICO benefit card before, during, or within 48 hours of the first business day after admission. If the Case Management Co-ordinator authorizes the services then they will be paid to the plan benefit maximums.
- What happens if I am traveling outside the Cayman Islands?
- If you travel to the United States, you will be covered subject to the Case Management Co-ordinator pre-authorization approval. However, non-emergency and unauthorized services will not be covered.
- What is an Overseas Case Manager?
- A Health Care Management Provider contracted by CINICO to determine the most appropriate treatment for you and your family.
- How does Overseas Case Management work?
- After receiving the information submitted by your physician and the Chief Medical Officer at the HSA, indicating that medically necessary services are approved which are not available at the HSA, the Case Management Co-ordinator will arrange and case manage your services at the medical provider contracted to provide you the service needed for your medical condition. The telephone number for the Overseas Case Manager is located on the front of your CINICO benefit card.
- Why does CINICO have an Overseas Case Management Co-ordinator?
- The Case Management Co-ordinator has access to hundreds of hospitals and thousands of physicians who provide you quality medical services when you need them.