fp Turks and Caicos

Although the NHIB, the government, Dr. Ewing, Mr. John Smith and a slew of others have tried to explain the system and what it will mean, the public support still does not seem to be there and the root of the issue at hand comes down to the benefits covered by the plan. The simple answer to what everyone is paying for is: the benefits.

This week the NHIB released the list of those benefits. It addresses three basic categories: coverage by “Preferred Providers”, coverage by “Contracted Providers” and coverage by the Ministry of Health (MOH).

In order to understand the plan, the first thing is the who and what each of those groups represent.

The top group is the Preferred Providers. In the simplest of terms, this refers to the two hospitals (Providenciales and Grand Turk). This means the services, which are included under the category Preferred Provider are the services one can obtain in the physical hospitals. In general, the hospitals are able to provide most regular procedures and check-ups a person could require, covered under the plan either free of charge or with a $10 co-pay. This means everything from doctor’s visits, well baby visits, pre- and post-natal care, acute and chronic illnesses, ER visits to dental care. The vast majority of the non-covered items are classified under the category of cosmetic or non-necessary procedures.

The second group is the Contracted Providers, which include private doctors or clinics throughout the islands who have agreements with the NHIP to be included in their plan. Unfortunately, while this group seems to be voicing the largest concern amongst the community who up till now have used their services, it is also the one which continues to leave the biggest questions in regards to the schedule of benefits.

NHIP is still working to find agreements with as many private doctors on island as possible to agree on some level of coverage the plan can provide for those services.

For example, under the current benefits, any person participating in the plan can go to the hospital for a regular doctor’s visit and pay only the $10 co-pay. If however, one chooses to go to a private doctor outside of the hospital, but within the network of Contracted Providers, depending on the agreement with that specific doctor, you will have to pay the difference between what the NHIP covers and what the doctor’s visit actually costs.

At this time, those agreements have not been completed, so it is not possible to give an accurate estimate as to what those costs may be. However, it is obvious that whatever the costs to the patient in the future are, it will be less than what they have paid at that same doctor to date. NHIB CEO Brian Hogan says the Contracted Providers contracts and benefits should be completed before the Dec 15th first payment deadline.

The final group is the Ministry of Health. The MOH is primarily responsible for the healthcare in the family islands which do not have immediate access to the hospitals in Provo and Grand Turk. Dr. Ewing says they are working to increase the capacity of primary health care services in the family islands, specifically to be able to handle initial emergency care.

Ewing says the facility in South Caicos has recently completed some renovations, so they are now equipped to offer physiotherapy, x-ray and laboratories. He said they are looking to expand the facilities in North Caicos, which service the island as well as sister island Middle Caicos.

The NHIP comes at a cost for each individual, but also provides a benefit for each individual on the island and to the society as a whole, which previously consisted of a 90% uninsured population. The successful operation of the hospitals also opens the TCI up to a tourist and investment target group that thus far has not embraced our beautiful country: retirees. This could provide necessary economical stimulus for the future.

For the complete list of covered benefits, click here .