I am in my mid-50’s and was made redundant a few months ago. I am now without income and have been unable so far to find a job to support myself. My health insurance through my last employers will end in a few weeks and I don’t see how I can afford to pay for a new plan even if I can find a provider that will take me on. What do I do?

Auntie’s answer: Being insured through your employer is certainly the easiest and most economical path to coverage, but you do have options for health insurance once your policy tied to your last job expires. Before I get into that, I feel I need to step onto a soapbox to say my piece about the health-insurance industry in Cayman, which is in great need of reform.

While comparisons to the industry in the US don’t really hold because of market size and diversity of medical needs, it nevertheless really irks me that the carriers in Cayman often refer to providing group health insurance. A true group policy spreads the risk among a large number of people so that those with serious health issues do not lead to outrageously expensive premiums for everyone insured under the same plan.

In Cayman, however, even if a company has group insurance, if one employee racks up a very large medical bill one year (for example, through serious illness requiring extended hospitalisation), it is more than likely that when the policy comes up for renewal, every employee will face a sobering hike in their rates.

There are many other issues that I could address (and hope to at some point) but you asked a specific question so I will step back down from the soapbox to answer your query.

Since the law in Cayman says you must be insured, once you are no longer employed you will need to apply for coverage as an individual. Without the economies of scale (such as they are) of group coverage, premiums on an individual policy can be quite high, depending on the plan you require.

You will need to do a bit of comparison shopping to find the best fit for you. Here is a link to the list of approved insurers from the Department of Health Regulatory Services.

If you find the private plans too expensive, the insurance companies also offer the very basic government-regulated Standard Health Insurance Contract (SHIC). The caveat is that you will no doubt find the coverage under this plan to be much less comprehensive than the private policy you now hold.

You can also apply to be covered under SHIC through CINICO (Cayman Islands National Insurance Company) at a lower rate than through private insurers if you qualify. Participation through CINICO under what is called the “Affordable Plan” is available to residents who are younger than 60, as well as their families. (The “Silver Plan” is for individuals only, who are 60 and over). For more information, go to the CINICO website or call 949-8101.

And, importantly, if you still cannot manage the premium of the SHIC plan, other help is available. Anyone without the resources to afford health care or insurance coverage can apply to the government’s Needs Assessment Unit (here is the link to the website or call 946-0024) for assistance.