Bermuda’s evolving healthcare landscape has raised concerns, as insurers and providers have merged, blurring the lines between the provision of medicine and insurance.

An independent pharmacist has conceded the changes have affected pharmaceutical delivery and choices for patients.

Sheryl Martins, CEO of Caesar’s Pharmacy on Somerset Road in Sandys, said some changes have been a source of worry.

She said: “There seems to be a change with insurance collaborations and/or mergers, that definitely has affected pharmacies, or certainly some pharmacies.

“So that's the biggest concern, I guess, if you want to say, among independent pharmacies right now, because that definitely will affect the business side of things.

“Also they affect the choice that patients have. I think choice of where to collect their prescriptions is important, and that's definitely been eroded.

“So it's a major concern, but that seems to be a trend, the monopolies in Bermuda, to be honest with you, and not just pharmacies. But that is a trend that I see that is, I think, concerning.”

Ms Martin’s remarks came as Caesar’s and the MoonGate Insurance Group discussed with The Royal Gazette the progress of their collaboration, which has allowed the pharmacy to expand its distribution into Hamilton.

The principals made it clear that their agreement is not a merger, but simply a case of businesses that are working together.

After several months of MoonGate hosting a Caesar’s Pharmacy outlet in medical offices at Sofia House on Church Street, both parties agree the arrangement has worked well.

MoonGate Group CEO Leon Bascome said the company has continued to seek other collaborations and the Caesar’s arrangement made sense for the company and for the public.

“We’re excited about the future,” he said.

Mr Bascome said he would consider the use of the premises by doctors, with one already on board and the appropriate facilities on hand to see patients.

MoonGate is not a primary health insurance company, but a non-regulated provider.

One of its key offers is HealthGap, which does not provide stand-alone medical coverage.

Instead, it is designed to supplement and enhance an existing basic health insurance plan — such as the Government's Health Insurance Plan, FutureCare or basic policies from standard private insurers.

Mr Bascome said: “We had some discussions with the health insurance department. We were able to determine where some of the shortfalls were. And from that, we worked with Age Concern and Dr Fleming.”

He said: “Health Gap includes coverage for air ambulance. And then we have over 100 healthcare providers in Bermuda that provide discounts for various services. So, you know, we're continually expanding that product as well.”

Mr Bascome said: “If [one of our clients] needs to be flown out [of the island for a medical emergency], then that's where we would respond. So they would basically have that prepaid.

“And [without cover] those costs — we've seen go up from $25,000 to nearly $50,000. So it's very important that we get the word out.”

He said: “We've been consistent. We try to keep our pricing fairly stable. We haven't changed in the last six years. We're really proud to say that.

“It did have to increase just after Covid because during Covid we were actually flying a lot of people out, because no commercial airlines were flying. And so now things seem to have settled back down. And so I'm glad that we've been able to keep the pricing pretty stabilised.”