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Fee Schedule

The following lists the benefits covered under:

Seafarers & Veterans Medical Benefits

Effective January 2006	In–Network Health Services Authority or Local Providers (with CMO approval)	Overseas Providers (with CMO approval)
Maximum lifetime benefit amount	1 million $CI	1 million $CI
Maximum Calendar Year	n/a	n/a
Maximum per Medical Indicent	100%	90%
Deductibles	None, covered by plan	None, covered by plan
Emergency Medical Services (inclusive of emergent medication, drugs, and ambulance)	100%	90%
Outpatient Routine Medical Primary Care Office Visits, Specialist Office Visits, Diagnostics, Routine Laboratory Tests, Radiological Studies, Physical Therapy, Diabetic Insulin & Supplies	100%	90%
Home Health Care (as approved by C.M.O.)	100% (requires prior inpatient stay)	not covered
Prescription Drug and Medication	100%	not covered
Haemodialysis	100%	90%
Chemotherapy (including radiation therapy)	100%	90%
Inpatient Benefits/Ambulatory Surgery Benefits — a hospital semi–private room or intensive care unit — physician, specialist and surgeon services including Ambulatory surgery performed in a licensed medical facility — anethesia, use of operating room and recovery room — full nursing services — standard surgical supplies — laboratory and pathological studies — Physiotherapy, inhalation and other facilities acilities — X–ray and ultrasound	100%	90%
Mental Health	100%	not covered
Substance Abuse	100%	not covered
Chiropractor Visits	100%	not covered
Hospice Care (as approved by C.M.O)	100%	not covered

* All medical services that are provided by either a local or overseas provider without Chief Medical Officer (CMO) approval will not be covered.

* Employed spouses and children are covered for local benefits, but not for overseas benefits

* Unemployed spouses or widows are covered for overseas benefits.

Seafarers & Veterans Dental Benefits

Effective July 2007	In-Network Health Services Authority or Local Providers (with CDO approval) or Overseas Providers (with CDO approval)
Preventative, basic restorative services are covered. Major dental services are covered subject to preauthorization by the Chief Dental Officer.
Cleaning & General Hygiene	100%
Bridges	Not Covered
Dentures	50% (with C.D.O. approval)
Cosmetic Dentistry	Not Covered
Orthodontia Services	50% (maximum to age 18 years with C.D.O approval)
Periodontal Services	50%
Porcelain Crowns	100% (with C.D.O. approval)

* All dental services must be performed at an HSA facility

* All dental services that are provided by either a local or overseas provider without Chief Dental Officer (CDO) approval will not be covered.

Seafarers & Veterans Vision Benefits

Charges for vision care services and supplies are covered as follows:
Eye Exam	One exam in a 24–month period to a maximum of CI$ 40
Frames	Not covered
Lenses or Contact Lenses Single vision, bi–focal, tri–focal, progressive & lenticular	One pair in a 24–month period

Last Updated: 2010–04–28