Getting insured with a pre-existing condition
I am a Caymanian with a medical pre-existing condition. I’m finding it very hard to get a job and I think it’s because adding me to the company health insurance will raise the rates for everyone. What are my options? Can I get personal insurance that I can afford?
Auntie’s answer: I was able to get some information on your question but I do not think you will be completely satisfied. An official with the Health Insurance Commission first of all addressed your job-hunting issues, saying, “We hope that an employer would not discriminate against a person because of a pre-existing medical condition.”
While noting, “The commission cannot compel any employer to hire an individual,” he pointed out “an approved insurer would be in contravention of the health insurance legislation if they declined to offer the Standard Health Insurance Contract to an individual who is resident in the Cayman Islands because the individual may have a pre-existing medical condition”.
But while you have to be offered insurance, the official explained that your premium may be higher than the standard rate, depending on the pre-existing condition. There may be some leeway in that premium, though, because the “increase in premium would be assessed and where appropriate approved by the commission”, the official explained.
For more information, you can call the Health Insurance Commission at 946-2084 or go to the Department of Health Regulatory Services website.
Category: Ask Auntie, Health Insurance Questions
If you all are healthy ,why does any one need health insurance? I was very healthy when I was younger and paid for health insurance in case. When I got older and went through the stresses of life I got fatter . So I must be thrown under the bus ? Health insurance was created for such individuals . It was not created for the healthy.
In the Cayman Islands the health insurance companies can do as they please. They practically want you to sign a guarantee that you will never be sick and have to make a claim.
The reality is that you need to find an understanding doctor (there are plenty in Cayman), NOT declare the pre-existing condition and then pretend it started after your cover commenced. It is unfortunate (and illegal) but it’s also the only way to survive and get the care you need and therefore, in my humble opinion, justified.
Do not forget that this problem has been created by previous ministers of health anthony eden and gilbert mclean.
Both enjoying an excellent healthcare package on YOUR expense.
As far as I am aware, the group insurance policies offered in Cayman by employers offer US-style private health insurance coverage. Even where the policies are offered, pre-existing conditions are typically excluded. Accordingly whilst an employer may hire & offer this insurance therefore not discriminating against the employee , the policies offered inherently discriminate. Unfortunately as far as I can see, the CINICO fallback is also inadequate. Employers know this, and no doubt worry about the consequences of hiring an employee whose work may be impacted by excluded conditions which leave employees vulnerable to poor healthcare, hence why there is at least a perception that employers do not hire (effectively discriminate) persons they believe have “difficult” or pre-existing health conditions. Ultimately, this situation leaves employees, and those people with pre-existing conditions like myself, with a disincentive to working in Cayman. It is a very sad and unfortunate situation. Only legislative reform with changes in the Cayman health care system can possibly remedy this. There MAY be some private international policies, again US-based, which individuals can apply for. These sometimes can include pre-existing conditions often at an extortionate premium of tens of thousands of dollars per year. The other alternative is to work in countries with a universal healthcare system, such as the UK, although one should appreciate that there are limitations on that system too, for example due to funding caps and something of a geographical lottery, as is seems to be the case in the UK. My personal view drawing from my experience is that the earlier in life that a person takes out their own international private health insurance the better chance they have of getting through life without being at the mercy of any one employer’s group policy or any one country. It may seem costly at first but when health problems hit a person, it becomes very easy to see that insurance is usually worth it. So for any young worldly-minded person reading this, that’s my recommendation. All just my personal view. Good luck in your job search. Keep persevering and be creative to find a solution that works for you.
– Anonymous
If Insurance companies wants to raise premiums because of one specific reason. Then i think it could be called DISCRIMINATION , but ask the local Human Rights Commission or a Lawyer..
Then everyone can join the ones that are being discriminated against and fight for your own benefits, but again ask a Lawyer .
Technically pre existing conditions ARE NOT COVERED. The standard will cover a whole $100.00…remember when you get insured with pre existing its called “AN INCLUSION”
Fat people are too much of a burden on businesses. The obese should have to pay at least 75% of the insurance bill.
I am going to sue you for discrimination against me .
So you say, but I bet you will just sit there and eat donuts instead. And then blame your “slow metabolism”.
I agree. Some people have a GLUTTANY problem and should be required to seek
Proffesional help
Oh Annie, I have a lot of experience with this one. If she has been declined coverage from two or more insurers CINICO is her only option. They will charge her based on her risk. So say she has diabetes, expect to pay around $400 per month for crap coverage. I mean complete crap, really no coverage at all. It just satisfies the requirements for the labor law. The government model is such a joke.
It Is unlikely that any private insurer would touch her with a ten foot pole, unless she works for a major player like Dart with a big enough pool to spread the risk. And even then she would be on SHIC which is SHI# and a complete farce as it doesn’t cover anything.
And last but not least, she should not be at a disadvantage, as the labor law only requires employers to pay 50% of the rate for a healthy person. So if you have issues that is on your dime, funny no one brought it up at elections. Why? Because they count on the ignorance of the voters.
I have the same issue and in the end needed to get my own health insurance through Cinico – however, only the basic plan was available to non-government employees. A couple of companies explained that they did not want the premiums for their other staff to rise and condition of employment at my current employer is that I have my own policy. Thankfully they do reimburse me for 50% of the monthly fees.
Businesses exist to make profit. It is standard to ask about serious medical conditions and if the cost of insuring those would be uneconomic or there is a candidate without such a burden it is a rational decision for an employer not to employ the candidate with a significant pre-existing condition.
Employers discrimate ALL the time. I have personally seen it in the work place. The insurance business is messed up big time. Additionally, there needs to be more prevention and preventative strategies by government to keep residents of the island thinking and acting on their health before it becomes severe. I say this in respect to health issues that can be improved by healthy lifestyles, eating right, exercising etc.
Why should the government be responsible for your lifestyle choices? If folks can’t figure out that eating fatty foods, lack of exercise and not getting enough rest contributes to a depletion in your quality of life, then something is really wrong.
Because it directly impacts society and the government. When they are not insured by private health ins companies, they become the government’s problem. In other countries healthy lifestyles are taught in schools at a young age. People don’t realize the ripple effects especially in smaller communities.
Yes something really is wrong. The more unhealthy people on island they higher we pay in premiums. It affects us all.
Nothing in this post suggested the author eats like me. BACON!
Another example of why we should not have followed the US into private insurance based health care funding. Hasn’t worked for them either. Here in Cayman, the insurance companies lobby is so strong that Radio Cayman, paid for by taxpayers as well as advertisers, allows the boss of one of them to come on regularly and sing the praises of ( i.e. advertise for free!)health insurance and how smart Cayman was to adopt this model (which has made him extremely rich). Sickening.
Our insurance cartel are only too happy to add “high risk” patients to company policies and raise rates across the board for everyone, healthy or not. Pretending high risk employees don’t move the needle for small-medium size company plans is a bit naive.
I believe the point is that they shouldn’t. (I’m not defending the insurance companies, just the answer.)