Frequently Asked Questions

NHIP:


Why is NHIP mandatory?

Why is NHIP mandatory?

For NHIP to work for anyone, it must include everyone. If enrollment was voluntary, those who are young and don’t need much care might choose not to enroll. This would mean only the sicker individuals would join the Plan and everyone would have to pay much more. This would make NHIP unaffordable. Also, if it was voluntary, as these young people aged and needed medical care, they would need to join the Plan and then there would not be enough money to pay for their services.

How will I know if my private doctor is signed up with the NHIP?

How will I know if my private doctor is signed up with the NHIP?

NHIP provides a list of all private doctors who have signed contracts. An updated list will be available on the NHIP website. The names of contracted private doctors can also be accessed by calling NHIP Customer Services.

Who will decide which services I can get overseas under the NHIP?

Who will decide which services I can get overseas under the NHIP?

The decision to send a person overseas is first a medical one, but it also has financial implications. Now that the new hospitals are operational, Interhealth Canada will determine if it can provide the medical services required by the patient. If they cannot, they will recommend that the patient be sent overseas for care. The Medical Director of NHIP, will review this recommendation to determine if the care for which the patient is being referred, is covered by NHIP. If the care is covered, the NHIP will approve the referral for overseas care, in consultation with Interhealth Canada. In this case the NHIP will be responsible for paying the overseas provider directly. NHIP will monitor overseas care to control costs. The patient will be responsible for paying any non-covered expenses directly to the overseas provider.

 

Private Insurance:

 

I have private health insurance. Why can't I just keep my private health insurance and not pay into NHIP?

I have private health insurance. Why can't I just keep my private health insurance and not pay into NHIP?

Having everyone contribute provides social equity. You can keep your private insurance but you must also join NHIP because everyone must be a part of NHIP for it to be financially viable. Each person’s contribution to NHIP will also allow us to have full access to the state-of-the-art health care facilities on Grand Turk and Provo, with a wide range of services.

I know it says that I would be free to keep my private insurance. But why would I need private insurance if I am adequately covered by NHIP?

I know it says that I would be free to keep my private insurance. But why would I need private insurance if I am adequately covered by NHIP?

While all your essential health care need will be covered through NHIP, you may still choose to retain your private health insurance if you want full access to private physicians, and more extensive benefits than the NHIP offers. For example, some private health insurance plans cover care in the United States with very few restrictions on providers. If this is important to you, then you may want to continue your private health insurance to supplement your NHIP coverage.

 

Contribution:

 

What will happen if people do not contribute? Will they be able to get care at the hospitals?

What will happen if people do not contribute? Will they be able to get care at the hospitals?

Contributing to the NHIP is mandatory for residents of the Turks and Caicos Islands. The new hospitals provide emergency care to everyone but will require payment in full at the time of service if the person does not have an NHIP card. If you are required to enroll in NHIP, but don’t do so, then you will end up paying twice: • You will have to pay the full costs of the care that the hospital provides. • You will need to pay all past due amounts to the NHIP including interest. • You may also be subject to a penalty and exclusion of certain health conditions if you don’t enroll in a timely manner.

How will the contributions be collected from employees?

How will the contributions be collected from employees?

Your portion of the contributions will be collected on a monthly basis on or before the 14th of every month. The employer will deduct your portion from your regular paycheck and pay it on your behalf to the NHIP. Contributions can be made through FCIB over the counter or online, Scotia Bank online only, and by cheques only at the NHIB’s customer services station in the Saltmills Plaza.

How did NHIP arrive at % contributions between employer and employee?

How did NHIP arrive at % contributions between employer and employee?

To arrive at the costs of NHIP, the actuarial assessment looked at the projected use and cost of local health care services, the cost of overseas care that would still be required and the administrative expenses to run the NHIP. To arrive at revenues, the Actuary first took the projected government transfers into the Plan. This analysis showed that, according to the utilization and unit cost assumptions, a payroll contribution of 6%, along with the Government’s transfers, would be sufficient to meet the health care needs of the people of the Turks and Caicos Islands.

Why isn't the wage ceiling the same as the NIB ceiling?

Why isn't the wage ceiling the same as the NIB ceiling?

Equity in contributions requires that those who earn more help to keep contributions affordable for those who earn less. Ceilings make sense in pension payments, because the amount of pensions paid out can be capped to match contribution rates. In health care there are no caps in benefits, so everyone is entitled to full health care coverage. The 5% contribution, which is lower than NIB, is only possible if people contribute according to their means.

 

Compliance:

 

How will my health care be impacted if my employer defaults on contributions?

How will my health care be impacted if my employer defaults on contributions?

Your employer is responsible for collecting employee contributions, adding the employer’s contributions and submitting the monies to the NHIP. If your employer fails to do this, then NHIP will impose stiff penalties. If you have done everything that you were required to do (e.g. enroll yourself and your dependents as required), then your care will still be covered under NHIP. However should you need medical treatment from the Cheshire Hall or Cockburn Town medical center, and your employer is not up to date with paying the monies to NHIB but deducting it from your salary, your employer will be responsible for paying off whatever medical procedures received.

Who will ensure that payments are made by all residents into NHIP?

Who will ensure that payments are made by all residents into NHIP?

The NHIB has a strong team of compliance officers who seek to ensure that all employers’ contributions are paid up to date on a timely manner. The NHIP legislation specifies stiff penalties for those who do not comply.

 

Special Groups:

 

Why is government paying for prisoners? Will these prisoners upon release have to pay back the government?

Why is government paying for prisoners? Will these prisoners upon release have to pay back the government?

The Government has a responsibility to provide medical care to persons while they are in prison. NHIP will be responsible for paying Interhealth Canada for the health services that it manages. So if a prisoner needs medical care through the facilities managed by Interhealth Canada, it will be necessary for NHIP to pay for this care on the prisoner’s behalf. The government will fund the NHIP to cover this cost. Once prisoners are released from prison, they will need to enroll in the NHIP and pay contributions just like everyone else.

How will health care for illegal immigrants be dealt with under NHIP?

How will health care for illegal immigrants be dealt with under NHIP?

Illegal immigrants are not entitled to benefits under the NHIP and will not be able to enroll in the NHIP. If an illegal immigrant requires emergency care at the hospitals, the staff will stabilize the patient for discharge, and require payment from the immigrant or their family in full at the time of service. They will also report the illegal immigrant to the Department of Immigration to take steps for repatriating the person to his/her own country.

What is the policy on tourists receiving health care since they would not have contributed?

What is the policy on tourists receiving health care since they would not have contributed?

Tourists will be not be eligible for the NHIP, but may, from time to time, need to use the health care facilities. In this case, they will need to pay in full directly for services.

 

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