HEALTH INSURANCE
The Sagicor CariCARE Medical Assistance Plan is a Comprehensive Major Medical Plan that functions on a reimbursement basis. This plan does NOT cover Vision, Dental, Maternity and Routine Services.
 
When claiming you must fully complete and sign the claim form and attach all relating itemized bills/receipts.
 
Refund cheques are collected from The Office of Student Services during office hours Monday – Friday from 8:30 am – 4:30 pm.

** Reimbursments take approximately three (3) weeks.

For further assistance please contact the Health Plan Administrator at 417-4165/4915

Schedule of Benefits
UNIVERSITY OF THE WEST INDIES
CARICARE HEALTH INSURANCE SCHEDULE OF BENEFITS
Policy Number GB1000768
   
Comprehensive Major Medical  
Benefit Maximum for each student $100,000.00
Benefit Period (University Lifetime)
Deductible per calendar year $50.00
Benefit Payment: Co-insurance Percentage
On the First $20,000 per Calendar Year 80%
Thereafter for the remainder of the Calendar Year 100%
   
Carry Over provision Last Three (3) Months of Calendar Year
   
Pre-existing Condition (Maximum per Disability) Applicable to New Students ONLY          $1,000.00
   
Internal Plan Limits: (Applies toward Lifetime Major Medical Maximum)
AIDS or AIDS-related illnesses $20,000.00
   
   
Daily Room and Board Limit (Subject to the deductible & Co-insurance)
Local  $300.00
Overseas Caricom $1,000.00
Intensive Care 2.5 times ASPRR
ASPRR Means "Average Semi-Private Room Rate"  
   
Surgical Expense Benefit  
Benefit Payment  After the deductible 80% of R & C Charges
   
Other Hospital Services Benefit  
Benefit Payment  After the deductible 80% of R & C Charges
   
Miscellaneous Benefit  
Benefit Payment  After the deductible 80% of R & C Charges
   
Prescription Drug Benefit (Not Subject to the deductible)
Benefit Payment  80% of R & C Charges
   
Diagnostic Expense Benefit  
Benefit Payment  After the deductible 80% of R & C Charges
   
Doctors Visit Benefit (Office, Home, Hospital)
Benefit Payment  
Outside of University Panel After the deductible 80% of R & C Charges
Within Panel $30.00
   
Specialist(by referral only)  
Benefit Payment  
Out of Network After the deductible 80% of R & C Charges
Within Network $50.00
Within Panel Not Subject to Deductible or Co-insurance
   
Emergency Doctors Visit Benefit (Home/Hospital)  
Benefit Payment After the deductible 80% of R & C Charges
   
Psychiatric Benefit (Subject to the deductible & Co-insurance)
Lifetime Maximum (Applicable to Out-patient & Hospital Care) $25,000.00
Out-patient Care  
Maximum per Treatment $50.00
Co-insurance percentage 50%
Maximum visits per year 20
Hospital Confinement  
Co-insurance after deductible 80%
   
Physiotherapy and other Health Care Professional Groups  
Maximum per visit  $40.00
Benefit Payment  After the deductible 80%
   
Local Ground Ambulance  
Benefit Payment Percentage  After the deductible 80% of R & C Charges
   
Medical Air Transportation Benefit  
Maximum Number of Trips per Calendar Year 2
Airfare (Subject to the deductible & Co-insurance)
Benefit Maximum per calendar year $1,500
Benefit Payment  Percentage 80%
Emergency Air Ambulance ( Not Subject to the deductible  or Co-insurance)
Benefit Payment percentage 100%
Medical Air Transportation Limited to the Caribbean Region
   
Preventative Care  
Annual GYN and Pap Smear test for each female student $35
Annual Proctology/Prostate Examination for each male student age 40 and over $35
   
*R & C - Reasonable and Customary
   
NB 80% of the Reasonable and Customary Charges are eligible for reimbursement
   
Prescription Drugs Reimbursement/Payment limited to "prescribed drugs" as setout and required by law in the insurer's jurisdiction

The Office of Student Services
Tel.: (246) 417-4165/6/7 Fax: (246) 424-5348 | Email: studentservices@cavehill.uwi.edu