Alerts

Alerts

  • Free health screenings are available to the public through the Community Health Nursing Team on Friday 1 September in Dr. E.F. Gordon Square, Hamilton and on Friday 22 September in King's Square, St. George, both from 4:00 pm to 8:00 pm. The Community Nursing team is "Taking it to the Streets" to check blood sugar, blood pressure, provide cardiac risk assessments and more.

HIP and FutureCare Benefits

The Health Insurance Plan (HIP) and FutureCare are plans provided by the Health Insurance Department (HID).

The two plans offer dental benefits, doctor’s visits, in-patient and out-patient care at the hospital and overseas care.

Enrollment in the different plans is based on the age and benefit needs of the applicant.

Who qualifies for which plans and the exact benefits can be found in the HIP & FutureCare Plan Guide.

The Table below, provides an overview of the benefits of the plans and a comparison between HIP and FutureCare:

 

 

HIP

FutureCare Plan

 

Local In-Patient (King Edward Memorial Hospital (KEMH) / Mid-Atlantic Wellness Institute (MAWI))

 

Hospitalizations

All costs associated with overnight stay. E.g. room and board, nursing

  • KEMH - Covered at 100%
  • MAWI – Covered at 100% up to 40 days in-patient stay
  • New born delivery – covered at 100%

All costs associated with overnight stay. E.g. room and board, nursing

  • KEMH - Covered at 100%
  • MAWI – Covered at 100% up to 40 days in-patient stay

 

 

Profession Physicians Fees

During hospitalization (Maximums per admission)

  • Surgery - $2,114
  • Anesthetist - $1,171
  • Internal Medicine - $1,643
  • Hospital Visit Specialist - $1,004
  • Hospital Visit GP - $792
  • Obstetricians - $3,442

-Based on Bermuda Hospitals Board (Medical and Dental Charges) Order 2015 and Health Insurance (HIP) (Additional Benefits) Order 1988

During hospitalization (Maximums per admission)

  • 75% reimbursement per admission

 

 

 

- Based on Health Insurance (FutureCare Plan) (Additional Benefits) Order 2009 

 

Local Out-Patient Services (KEMH and Standard Health Benefit (SHB) Approved Providers*)

 

Emergency Room Visits

Covered at 100%

Covered at 100%

 

Diagnostic Imaging

Covered at 100%

  • Diagnostic imaging includes MRI, CT Scan, Ultrasound, X-Rays

 

Covered at 100%

  • Diagnostic imaging includes MRI, CT Scan, Ultrasound, X-Rays
 

Supplemental Diagnostic Imaging and Cardiac Diagnostics

 

 

Not Covered

 

 

 

Covered at 80% at KEMH and BHeC approved providers.

 

Laboratory Services

  • At BHeC-approved facility
  • Labs performed at KEMH – covered at 100%
  • Supplemental – approved facilities, covered labs and fees

 

  • Labs performed at KEMH – covered at 100%
  • Supplemental - approved facilities, covered labs and fees

 

 

SHB Wellness Benefit

  • Via BHB D.R.E.A.M. Centre and Bermuda Diabetes Association

Covered at 100%

  • E.g. Fall Prevention, Diabetes Counselling, Hypertension, Smoking Cessation, Asthma/COPD Education and Nutrition Consulting.

 

 

Covered at 100%

  • E.g. Fall Prevention, Diabetes Counselling, Hypertension, Smoking Cessation, Asthma/COPD Education and Nutrition Consulting.

 

 

 

BHB Employed Specialists

  • As per Bermuda Hospitals Board (BHB) (Hospital Fees) Regulations 2015

Covered at 100%

Covered at 100%

 

Artificial Limbs and Appliances

  • Policyholder must have 12 months continuous active policy to be eligible for this benefit
  • At BHeC approved facility

$100,000 lifetime max

$100,000 lifetime max

 

Home Medical Services Benefit

  • Physician assessment and referral required
  • At a BHeC approved provider.

Services at a high-level:

  • Registered Nurse Visits
    • Wound care
    • IV Therapy and associated drugs
  • Palliative Care

 

Services at a high-level:

  • Registered Nurse Visits
    • Wound care
    • IV Therapy and associated drugs
  • Palliative Care
 

Kidney Transplant

$150,000 benefit for kidney transplant

$150,000 benefit for kidney transplant

 

Dialysis

  • At a BHeC approved facility

Covered at 100%

Covered at 100%

 

Anti-rejection Drugs

Covered at 100%

Covered at 100%

 

HID Supplemental Benefits

 

GP Office Visits

$42 per visit - max 4 visits per year

$46 per visit

 

Specialist Physician Visits

  • Includes urology at KEMH and in community
  • $170 for two initial consults max/year
  • $75 for three follow up visits max/year
  • $170 for two initial consults max/year
  • $75 for three follow up visits max/year
 

Wellness Benefit

80% coverage per visit/session to a max of $35 per visit, up to 6 visits per year

E.g. Asthma, nutrition, diabetes, lifestyle counseling, fall prevention and counseling for smoking cessation

80% coverage per visit/session to a max of $35 per visit, up to 6 visits per year

E.g. Asthma, nutrition, diabetes, lifestyle counseling, fall prevention and counseling for smoking cessation

 

Prescription Drugs

Not Applicable

$2,000 per policy year maximum

  • 100% paid for generic drugs
  • 80% paid for brand name drugs
 

Personal Home Care services:

  • Requires Prior Approval
  • Policyholder must have continuous active policy for 12 months prior to being eligible for this benefit

 

$60,000 max per year which includes the following services and rates:

  • Personal Caregiver - $15 per hour (max 40 hours per week)
  • Skilled Caregiver - $25 per hour (max 14 hours per week)
  • Adult Day Care - $50 per day to a max of $200 for 7 days
  • Registered Nurse Visit - $75.00 per visit to a max 12 visits per policy year

 

$60,000 max per year which includes the following services and rates:

  • Personal Caregiver - $15 per hour (max 40 hours per week)
  • Skilled Caregiver - $25 per hour (max 14 hours per week)
  • Adult Day Care - $50 per day to a max of $200 for 7 days
  • Registered Nurse Visit - $75.00 per visit to a max 12 visits per policy year
 
 
 
 

Vision Benefit

  • Applicable either in Bermuda or Overseas
  • Eye examination and prescribed eyewear – not covered.

 

  • Eye examination - $50 per policy year
  • Prescribed Eyewear - $200 max per policy year
 

Group Psychotherapy Sessions

Not Covered

$46 per visit

  • max 24 visits/year
 

Clinical Psychologist Visit

Not Covered

$78 per visit

  • 12 visits per policy year
 

Psychiatrist Visit

Not Covered

$131 for initial

  • $81 for follow-up visits
 

Physiotherapy or Occupational Therapy Visit

Not Covered

$35 per visit

  • max 12 visits per policy year
 

Speech Therapy Session

  • Referral required from GP

Not Covered

$42 per visit

  • max of 12 one-hour sessions per policy year
 

Chiropodist Visit

Not Covered

$41 per visit

  • max 6 visits per policy year
 

Allergy Services

Not Covered

$500 lifetime maximum

  • Includes test and treatment
 

Registered Nurse Home Visits

See Personal Home Care and Home Medical Services benefits above

 

12 visits per year - ordered by a physician

See Personal Home Care and Home Medical Services benefits above

 

Physician Home visits

$82 per visit

$82 per visit

 

Overseas Treatment

     
  • Referrals required unless travelling abroad & a medical emergency arises
  • Treatment must be medically necessary and unavailable in Bermuda.
  • Care coordinated through GMMI
  • See Guide Overseas Section for details
  • 60% coverage at HID preferred facility
  • 50% coverage at a non-HID preferred facility
    • If travelling abroad, only emergency treatment covered

 

 

 

 

 

 

  • 75% coverage at HID preferred facility
  • 65% coverage at a non-HID preferred facility
    • If travelling abroad, only emergency treatment covered

 

 

 

 

 

 

Dental Benefits: Paid in Accordance with the Bermuda Dental Fee Schedule

 

Basic Dental Services:

Pre-Estimate required from your Dentist prior to undergoing extensive dental procedures

 

Preventative and Diagnostic

  • 75% of Fee Schedule
  • Policy Year: Unlimited
  • Lifetime: Unlimited
  • 100% of Fee Schedule
  • Policy Year: Unlimited
  • Lifetime: Unlimited
 

Exams, Consultations, Polishing, Scaling or Root Planing, Fluoride

  • 75% of Fee Schedule
  • Policy Year: Unlimited
  • Lifetime: Unlimited
  • 100% of Fee Schedule
  • Policy Year: $1,200.00 maximum
  • Lifetime: Unlimited
 

Surgical and Minor Restorative

  • 75% of Fee Schedule
  • Policy Year: Unlimited
  • Lifetime: Unlimited
  • 100% of Fee Schedule
  • Policy Year: Unlimited
  • Lifetime: Unlimited
 

Endodontics

Not Applicable

Root Canal Services

  • 100% of Fee Schedule
  • Policy Year: Unlimited
  • Lifetime: Unlimited
 

Periodontic

Not Applicable

Treatment of Gum Disease

  • 50% of Fee Schedule
  • Policy Year: $1,500.00 maximum
  • Lifetime: Unlimited
 

Major Restorative

Not Applicable

Crowns, Inlays, Onlays, Dentures or Bridgework, Braces, Dental Implants and Related Procedures

  • 80% of Fee Schedule
  • Policy Year: $3,000.00 maximum
  • Lifetime: Unlimited
 

 

 

 

 

 

 

Persons 65 and older should apply to HID for the Certificate of Entitlement (COE). Find out more information on the Certificate of Entitlement page.

If you are a healthcare provider and are seeking reimbursement from HID for claims, find out how to register and submit claims on the HID Provider page.

  

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