In Cayman, it is required by law for every resident to have the minimum health insurance plan, which covers basic medical expenses.
Plans vary from the basic SHIC to very comprehensive major medical world-class premium plans. The Cayman Islands Monetary Authority and the Health Insurance Commission license and regulate the health insurance companies together.
The SHIC plan is the primary, Government-regulated contract and covers about a quarter of Cayman’s residents. However, most employers offer higher than mandated coverage and all other health insurance plans are based around the Health Insurance Laws and Regulations, including an outline of the basic SHIC benefits. These cover, at minimum, up to CI$100,000 major medical per annum, with a CI$1,000,000 lifetime maximum for each person. This includes hospital, surgical, chemotherapy and radiation services, along with emergency care, including air ambulance. All SHIC plans have very limited local outpatient benefits and any overseas care is usually restricted to the kind of major care unavailable in Cayman. The more comprehensive plans offer wider access to overseas services, larger per annum and lifetime allowances (e.g. CI$500,000, CI$1,000,000 and CI$2,000,000 or higher could be available within a calendar year), fuller prescription coverage, more outpatient services and options for dental, optical and life insurance benefits.
The cost of insurance plans will vary with age, gender, benefits and employer size. For example, a basic SHIC plan without dental and vision currently costs in the vicinity of CI$167 per month, per employee (possibly higher for older ages and/or pre-existing conditions), whereas a medical plan with enhanced outpatient benefits typically runs 20% to over 100% higher than SHIC. More comprehensive benefits, including doctor and specialist visits, extra preventative care, dental, vision and prescription coverage, can cost up to CI$500-CI$1,300+ per month, per individual, and about CI$450-$1,200+ without dental or vision. Some insurers use a three-tier rate structure, whilst most use five-family tiers. As a general rule, adding one dependant is about twice the single monthly cost and adding two or more dependants is usually in the range of three times the employee-only monthly premiums, with adding spouses often being more expensive than adding children. If a Caymanian resident cannot afford to cover themselves or their dependants on a health insurance policy, they should apply to the Needs Assessment Unit (www.nau.gov.ky) for assistance with coverage or shortfalls in their benefits.
If any employer or individual wishes to obtain extra coverage over and above that which the company that employs them provides for, including the Government, they are able to do so, but beware that the Health Insurance Commission cannot regulate the rates charged. All medical payments by insurers are based on the Standard Health Insurance Fee (SHIF) schedule, which can be found at www.dhrs.gov.ky. (Look for the ‘Standard Health Insurance Fees’ on the Health Insurance Commission page.) You can find the details of various Insurance Benefits, rates, claim forms and packages on the insurers' websites. For instance, see CG Coralisle's forms, (previously known as CG Britcay.)
The high cost of our health insurance has been known to discourage people from retiring here. Keep in mind that under some group plans, the amount available per annum may reduce upon retirement and most employers in Cayman do not extend health insurance benefits to retirees. See the Retiring in Cayman section for more advice.
Most medical, and some dental, practitioners accept local insurance ‘on assignment’ provided the insurance company guarantees payment and the deductible, if applicable, has been met. This means that the doctor or dentist will claim work done directly from the insurance company on your behalf. Anything not paid by your insurance company is your responsibility. If any employer or individual wishes to obtain additional coverage above what is given by the company with which they are employed, or the Government, they are able to do so, but beware that the Health Insurance Commission cannot regulate the rates charged. All medical payments by insurers are based on the Standard Health Insurance Fee (SHIF) schedule, which can be found at www.dhrs.gov.ky – look for the ‘Standard Health Insurance Fees’ on the Health Insurance Commission page.
Medical providers are not required to charge within the SHIF, and balances above the SHIF are the patient’s responsibility. For substantial medical services, it is not unreasonable to ask for a written quote and request that it include a ‘pre-determination of benefits and proposed costs’ in addition to the ‘pre-approval of medical necessity’. If a retiree or visitor to Cayman requires medical assistance on-Island, they will usually pay upfront for services, keep all receipts and submit a claim once they return to their home country. The receipts will usually need to be fully itemised with diagnosis information and include the currency used and international disease codes. If you are a visitor, you should request that a claim form be completed using Cayman’s standard claim form. It is advised that you call your insurance company or review your policy before travelling to Cayman to verify how your benefits will work overseas. You may also wish to check if your insurance network extends to any local providers, as some insurance companies have already set up a relationship with local providers, which can save you out-of-pocket costs. However, it is not mandatory for medical facilities to accept overseas insurance. Residents who will have relatives visiting are recommended to inquire about their visitors’ insurance, too. If your visitors’ insurance will not cover them whilst in Cayman, they should be encouraged to seek a travel policy to protect them (and to protect you from being asked to sign for financial responsibility if they become ill or injured).
For more information on health insurance for kids, pick up a copy of our sister publication’s 2024 edition of Cayman Parent magazine.
For more information, you can also visit the Health Insurance Broker and Health Insurance Companies page.
The following are highly recommended companies offering health insurance plans in the Cayman Islands.
