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House: changes to HIP and FutureCare

Jeanne Atherden

Four new benefits and one improved benefit will be introduced for HIP and FutureCare policyholders — but premiums will also go up for 2015-16.

The changes proposed by the Health Insurance Department (HID), will be implemented on September 1, Jeanne Atherden, the Minister of Health, Seniors and Environment, told the House of Assembly today.

The HIP premium will be raised from $390 to $433.31 and the FutureCare premium will increase from $450 to $504.21, the Minister said, whereas a new HIP Youth premium will be $190.

Ms Atherden said that premiums have had to increase because of escalating healthcare costs, a significant rise in claims and an increase in the Standard Health benefit rate.

“Healthcare system costs have risen to unsustainable levels, and we must continually review and remind ourselves and the residents of Bermuda that our goal of offering accessible and affordable healthcare is often a conundrum,” Ms Atherden said.

“The proposed changes mark a strategic shift in our delivery of health services which is designed to provide better patient outcomes and population wellness in relation to the significant investment made by Government into the health of our citizens.”

Ms Atherden added that “worrying population health statistics and escalating healthcare costs” have made the changes necessary.

They include a new personal home care service aimed at reducing the length and number of hospital stays by enabling the elderly to age at home.

“This benefit will provide services that assist in activities of daily living to be brought to you so that you have support to remain in your own home, even as your circumstances change,” Ms Atherden said.

To improve chronic disease management, an increased number of specialist visits will be offered and health and wellness benefits will be introduced for preventive care management.

“The increased coverage will enable you to see your specialist more frequently and provide better disease management, and decrease your co-pay,” Ms Atherden told the House.

She added that when combined with the new wellness benefit, this will result in a more comprehensive approach to chronic disease management through better management of chronic illness and a more focused approach on prevention, wellness and making better lifestyle choices.

And through a new youth coverage benefit, children up to the age of 21 will also be covered for specialist, dental and overseas care, when medically necessary and unavailable in Bermuda.

The Health Insurance Department has also made changes to an existing benefit for policyholders by introducing a new overseas preferred provider network.

“HID has developed an Overseas Preferred Provider Network in response to the escalating cost of overseas treatment,” Ms Atherden said.

Within the network, HIP will continue to pay 60 per cent of usual and customary charges and FutureCare pays 75 per cent.

However, 10 per cent less will be paid for HIP and FutureCare claims that are out of the preferred provider network and elective treatments, second opinions and experimental treatments are not covered.

Ms Atherden told the House that “substantial savings will result from this policy with no degradation in quality of care and patient outcomes”.