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Types of Coverage

Local Coverage: The primary network provider is the Cayman Islands Health Services Authority (CIHSA). Most CIHSA services do not require preauthorization. You should simply present your CINICO identification card and photo I.D. to register at the CIHSA.

 

A Referral is created when you have been treated by a Physician at the CIHSA and they are unable to provide the necessary medical or dental care, the treating Physician will then seek approval from the Chief Medical Officer or Chief Dental Officer, respectively, for the service(s) to be provided by another local provider.

 

Overseas Coverage: If you have been treated by a CIHSA specialist and it is decided that the necessary medical care cannot be provided locally, then that CIHSA specialist will seek approval from the Chief Medical Officer for the service to be provided at an overseas medical facility. Based on the required medical service, an in-network provider in the United States, Canada, Jamaica or another country will be selected.

 

Emergency Overseas Coverage: To ensure coverage for an emergency service in an overseas medical care facility, the patient, patient's family member, the medical care facility or attending physician MUST contact the Care Management Co-ordinator at the number listed on the back of your CINICO benefit card before, during, or within 48 hours of the first business day after the emergency treatment or admission. This is necessary to ensure that the emergency visit can be evaluated as falling within the plan benefits in order that the medical facility or the member can be paid for the services rendered.

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