Seafarers & Veterans
- Plan Description
- Eligibility Criteria
- Benefit Schedule
Coming Soon
Seamans and Veterans: As defined under the Health Insurance (Amendment) Law, 2003, are those who reside in the Cayman 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 1, 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.
If you qualify in all of these categories AND reside in the Cayman Islands, you will be eligible for coverage with CINICO.
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 KYD $ |
1 million KYD $ |
| 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% | 100% |
| 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
|
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 local and 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 KYD $ 40 |
| Frames | Not covered |
| Lenses or Contact Lenses Single vision, bi–focal, tri–focal, progressive & lenticular |
One pair in a 24–month period to a maximum of KYD $ 200 |
