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Seafarers & Veterans

  • Plan Description
  • Eligibility Criteria
  • Benefit Schedule

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Seamans and Veterans: As defined under the Health Insurance (Amendment) Law, 2003, are those who reside in the Cayman Islands and who:-

  1. 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
  2. First went to sea before January 1, 1985 or served in the armed forces before 1973.
  3. 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

  • 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 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

 

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