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HIP Medical Premiums and Benefits

HIP is an affordable health insurance plan designed specifically for full-time residents of Bermuda over the age of 18. 

HIP Youth is available to all children of Bermuda from birth to age 18, or 21 if enrolled as a full-time student in Bermuda.  They must be eligible for youth subsidy and the parent/guardian must be a HIP policyholder.

Download the HIP Enrollment Application – Compulsory (If Employed)
Download the HIP Enrollment Application - Voluntary

HIP Premiums

Effective 1st April 2016.

2016/2017 Premiums

Premium (per month) 

HIP

$433.31

HIP Youth 

$190.00

The following are the health benefits under HIP:

Physicians and other professional services

  • Office visits to a general practitioner at $42 per visit (Max 4 visits/year)
  • Office visits to a specialist physician when referred by a general practitioner at $170 for two initial consults and a total of three follow-up visits at $75 (maximum $565: non BHB specialist physicians)
  • Office visits for BHB employed specialists covered at 100%

In-Hospital Benefits

Maximum length of stay applies per hospitalization.

  • Surgery - $2,114
  • Anesthetist - $1,171
  • Internal medicine - $1,643
  • Hospital visit by a Specialist  - $1,004
  • Hospital Visit by a General practitioner - $792
  • Obstetrics - $3,442

Wellness Benefits

We offer supplemental benefits for self-management to promote healthier habits and lifestyles.

Wellness promotion benefit is covered at 80% per visit or session, to a maximum of six per year; at a reimbursement rate of $35 each.  Insured persons must be diagnosed with a chronic disease.

To be eligible, the programme must be HID approved.  Examples are asthma, nutrition, diabetes, lifestyle counselling, fall prevention and counselling for smoking cessation.

Wellness benefits are available through the SHB via the BHB Chronic Disease Centre with no co-pay for conditions such as asthma, nutrition, diabetes and hypertension.  Please consult with your physician.

Dental Benefits

HIP provides basic dental benefits at rates according to the Bermuda Dental Fee Schedule.  View rates and information on HIP dental care benefits.

Diagnostic Imaging Facilities

Services are covered or approved rates for:

  • Mammography
  • Bone densitometry
  • MRI (magnetic resonance imaging)
  • Diagnostic imaging
  • Laboratory services
  • Cardiac investigation

Other Benefits (local or overseas)

  • Artificial limbs and appliances ($30,000 lifetime maximum)
  • Dialysis treatment, anti-rejection drugs (kidney)
  • Contribution towards the cost of a kidney transplant not exceeding $100,000 ($30,000 from Standard Benefits plus $70,000 from Supplemental Benefits)

Personal Home Health Care Services for Long-term Care Needs

$60,000 maximum annual benefit per year, per policyholder.

The following benefits are included if specific qualifications are met:

  • Personal caretaking, companion or homemaking services at $15 an hour for a maximum of 40 hours per week
  • Nursing Aide Services at $25 an hour for a maximum of 14 hours per week
  • Adult Day Care services at $50 a day to a maximum of $200 for 7 days

Overseas Benefits

All overseas procedures and treatments require prior approval and must be medically necessary and not available in Bermuda.  Elective treatments, second opinions, and experimental treatments are not covered.  

Benefit coverage for "in preferred overseas network":

  • FutureCare: 75%
  • HIP: 60%

Benefit coverage for "out of preferred overseas network":

  • FutureCare: 65%
  • HIP: 50%

Please read the Overseas Health Treatment Coverage webpage.

HIP Youth Benefit

To provide children (birth to age 18* if they qualify for youth subsidy) with access to additional medical benefits, dental and overseas care that is medically necessary and unavailable in Bermuda

*Parent/Guradian must be a HIP policyholder

* HIP Youth is available to children up to the age of 21, if enrolled as a full-time student in Bermuda

  • HIP policyholders must enroll their dependents within three months of the effective date (1 September 2015)
  • Underwriting is not required, and pre-existing conditions are not excluded
  • Dependents receive the same insurance coverage as their parent/guardian
  • A youth dependent of a new HIP member must be enrolled immediately on the member joining HIP
  • Newborns must be enrolled within 30 days of birth
  • Should the youth dependents not be immediately enrolled in HIP they will be ineligible to enroll in the plan at a later time
  • On loss of insurance coverage elsewhere, a youth dependent may only be enrolled on HIP within one month (30 days) of such loss of insurance coverage

Exclusions

  1. Cosmetic or plastic surgery unless necessary to correct traumatic injury;
  2. Long-term custodial care in a nursing home;
  3. Eye or ear examinations to fit eyeglasses or hearing aid, except in cases of injury or damage to eye or ear
  4. Diagnostic services performed to satisfy the requirements of third parties;
  5. Visits solely for the administration of drugs, vaccines, sera or biological products
  6. Transportation or travel (other than local emergency ambulance service), airfare, air ambulance and hotel costs for overseas care are excluded;
  7. Medical treatment in the hospital that could be provided in a doctor's office during normal business hours;
  8. Treatment given or hospital facilities used that have not been prescribed by a registered practitioner, unless certified as urgent and necessary by a medical officer at the local hospital; and
  9. Claims that are 12 months or older than the date of service are considered outside timely filing and will be denied.
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