Heath Insurance
The Sagicor CariCARE Medical Assistance Plan GB1000768 is a Comprehensive Major Medical Plan which assists students in the payment of medical expenses. This plan does NOT cover Vision, Dental, Maternity and Annual Physical Examinations.
NOTE: CLAIMS MUST BE SUBMITTED WITHIN 3 MONTHS OF BEING INCURRED TO BE ELIGIBLE FOR REIMBURSEMENT
For further assistance please contact the Health Plan Administrator at 417-4915/4165
Schedule of Benefits
- When claiming you must fully complete and sign the claim form and attach all relating itemized bills/receipts.
- Please complete the Sagicor Direct Debit Form for refunds to be credited to your local Bank Account.
- If you have no local bank account, refund cheques can be collected from The Office of Student Services during office hours Monday – Friday from 9 a.m. to 12 noon AND 2 p.m. to 4 p.m.
NOTE: CLAIMS MUST BE SUBMITTED WITHIN 3 MONTHS OF BEING INCURRED TO BE ELIGIBLE FOR REIMBURSEMENT
For further assistance please contact the Health Plan Administrator at 417-4915/4165
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) | |
| 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% |
| 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 |
