Government had to scale back its promised new health insurance plan for seniors because of budget constraints.

Due to the economic downturn, only $10 million was allotted in the budget for FutureCare.

And Health Permanent Secretary Warren Jones said that amount only allowed for the 3,100 seniors already enrolled in HIP to have the new plan.

Those over the age of 65 who want to drop their costly private insurance in favour of FutureCare will have to wait at least a year, and maybe longer, for a hoped expansion of FutureCare, which unlike HIP, offers overseas care, unlimited doctor visits and in-home nursing care.

Exceptions are being made only for seniors not enrolled in HIP but who qualify for financial assistance. It is estimated there are about 8,000 seniors in Bermuda.

Mr. Jones said the public was not given more advanced notice about FutureCare eligibility because of the suddenness of the economic downturn.

"Back in October when the proposals were first put to the Government, we did not envision the economic picture that we are looking at today," Mr. Jones said.

"Once this became evident, around the beginning of the new year, the team had to backtrack and reconfigure the plan in order to meet the needs of those we deem to be most in need but also within a budgetary constraint of $10 million of incremental funding beyond funding that presently exists for seniors."

In a frank and detailed response to criticism of the plan's limit on eligibility (see Q&A for his full comments), Mr. Jones explained the total cost of the programme for the upcoming year is $38.6 million.

He said the cost will be financed by the seniors' higher premiums of $260 a month and a contribution of $10 million by the Government.

In the first year of FutureCare, it was also decided, he said, to divert the sum that every insured person presently contributes to HIP to FutureCare.

"This will result in another $2.5 million being transferred to support FutureCare," Mr. Jones said. "We are currently exploring various (other) avenues of funding."

Mr. Jones said FutureCare would be able to accept more seniors and add new benefits "over time".

"The upcoming year represents Phase I. In the present economic climate, we deemed that seniors presently on HIP and seniors deemed to be indigent (those who legally qualify for financial assistance) have the greatest need."

But Shadow Health Minister Louise Jackson said she is hearing from many anxious seniors who are having difficulty paying several hundred dollars a month and more for full or supplemental private insurance, and would like to join FutureCare.

"It's reprehensible," she said. "Affordable healthcare for seniors was one of the biggest election promises. I have spoken to many seniors who are upset because they knew nothing about all these restrictions and deadlines. It's unconscionable to leave them out."

Mrs. Jackson also criticised the monthly costs of the programme, which she said at $260 was beyond the means of those seniors most in need.

The answers below were provided by Health Permanent Secretary Warren Jones.

Q: The Government stated during the election build-up in 2007 that FutureCare would be for all seniors, how come this is only rolling out for those over 65 currently enrolled in HIP. Isn't that unfair?

Ministry of Health: The present economic situation provided us with an interesting challenge as it related to delivering FutureCare. The team had a mandate to deliver by April 1, 2009. Back in October when the proposals were first put to the Government, we did not envision the economic picture that we are looking at today. Once this became evident, around the beginning of the new year, the team had to backtrack and reconfigure the plan in order to meet the needs of those we deem to be most in need but also within a budgetary constraint of $10 million of incremental funding beyond funding that presently exists for seniors.

FutureCare will be able to accept more seniors and add new benefits over time. The upcoming year represents Phase I. In the present economic climate, we deemed that seniors presently on HIP and seniors deemed to be indigent (those who legally qualify for financial assistance) have the greatest need. This year is designed to meet that need. We recognise that there are seniors with major medical coverage with the private insurers who might find FutureCare attractive, at the present time we are pleased that they do have insurance coverage and felt the need to address those who may not or find the cost of private insurance prohibitive as the first priority.

Q: So realistically, going forward, what is the aim...to offer futurecare to all seniors who want it?

Ministry of Health: Over time FutureCare will be expanded to include all seniors who wish to be enrolled in the plan. As previously stated, this is Phase I. As we consider the economic climate and continue discussion with the private insurers, we will determine the scope of the FutureCare Plan.

Q: Does FutureCare replace HIP?

Ministry of Health: It is important to note that FutureCare does not represent an upgrade to HIP, but is a new and exciting healthcare programme designed specifically for seniors.

HIP was designed to provide cost effective, health care coverage for basic needs only. Under HIP, most seniors have to pay for the majority of professional services provided by specialists outside of the hospital. HIP was initially intended to be a plan for those employed persons who did not work for employers that had health insurance plans for their employees. HIP over time became the insurer of last resort.

In FutureCare, we are talking about an entirely new product with a specific focus on our senior population.

HIP remains for those persons under the age of 65 (self-employed etc) who wish to take advantage of this affordable plan.

Q. Explain the extra cost.

Ministry of Health: We are asking seniors to pay approximately $60 more per month for significantly more benefits. Under HIP, seniors were still expected to pay a considerable amount towards the services they were receiving in the doctors office etc. In most cases, FutureCare covers 75 percent of that service with the individual providing a co-pay for the difference. Therefore, in the long run we believe that FutureCare will cost less.

Government responds to Jackson, says there were no deadlines for seniors

Government last night dismissed claims by Shadow Health Minister Louise Jackson that seniors had missed deadlines to apply for FutureCare because they were poorly promoted.

Mrs Jackson had claimed that seniors who were members of HIP were told to fill out FutureCare forms by March 23 last Monday.

But in a strongly-worded statement, Health Minister Nelson Bascome said Mrs. Jackson's claims were wrong and had created unnecessary anxiety.

The Minister said: "Let me be clear, there is not now, nor has there ever been, an application process or deadline for persons to sign up for FutureCare.

"It was just a few weeks ago that I announced in the House of Assembly that FutureCare would be rolled out in phases. I noted that in the first phase FutureCare would only include those persons presently enrolled in HIP, persons turning 65 during this calendar year and those persons over 65 who qualify for Financial Assistance.

"No seniors who are members of HIP have been required to fill out a FutureCare application form. This unfounded statement does nothing but create confusion and concern amongst our senior population."

Mr. Bascome said people currently enrolled in HIP do not have to do anything "until such time as they receive their enrollment information from the Government Health Insurance Section".

He said that Government would be hosting Town Hall meetings, sending out brochures and providing information through the media. "There is no need for HIP clients to go to our offices to seek information," he added.

"This roll-out is designed to meet the needs of those who need it most. The present economic climate does not allow for enrollment of every senior that would like to be part of the programme. Persons who presently have insurance with the private sector are encouraged to maintain that insurance.

"We will be reviewing the economic situation and providing information as the fiscal year unfolds. This will determine the extent to which FutureCare will expand in the next year."