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.

• 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

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