Is your child covered? Understand Bermuda’s hospital subsidies. *iStock photo
Is your child covered? Understand Bermuda’s hospital subsidies. *iStock photo

FRIDAY, SEP. 28: Every year, around March and April, much is said about hospital subsidies. But, let’s be honest here – do you actually know what they are? If you don’t, you’re in good company, as most people haven’t the faintest idea and Bermuda Health Council is often asked to explain. Here’s our attempt to demystify the infamous subsidies.

What are the subsidies?

In Bermuda’s context it refers to government paying for hospitalization costs of special populations – like youth, indigent and seniors.

If a child goes to hospital the bill is sent to the Government’s Health Insurance Department (HID). If a senior aged between 65-74 years old goes to the hospital, whether they have insurance or not, the HID will get 80 per cent of the bill and the senior or their insurer will get 20 per cent of the hospital bill. If the senior is 75 or older, the government pays 90 per cent. And for indigent persons, the government picks up the full hospital bill.

This is why the subsidies are more accurately referred to as ‘patient subsidies’. Subsidies cover overseas hospitalization also and those bills make their way to HID as well. The subsidies programme has been in place for around 40 years.

Government claims to be paying a lot of money every year towards a subsidy for children’s healthcare, but this money does not seem to be helping me and my children. When my children were born they had to be added to my health insurance policy, which has just meant increasing costs for me each month. So where is this subsidy money going?

The subsidy money goes to local and overseas hospitals after care is provided. It’s like this: an adult’s health insurance premium includes cover for hospitalization and (usually) supplemental benefits, like doctor’s visits.

On the other hand, a child’s premium does not include hospitalization; only supplemental benefits. This is because the subsidy pays for hospitalization directly. So parents benefit from the subsidy in three ways: (1) lower premiums for their children; (2) guarantee that children will always be covered for hospitalization; and (3) protection for families from financial risk for children’s healthcare.

This is in keeping with the Universal Declaration of Human Rights, which treats childhood as a special category of person. It assumes that a community will share the cost of guaranteeing healthcare for children – just as we guarantee education for all children – in order to safeguard the health of the next generation who, in 40 years, will be taking care of us.

I have health insurance through my employer, but the insurer will not add my child. Does the insurer have to add my child?

The Health Insurance Act 1970 requires employers to provide insurance (for hospitalisation) for their employees and their non-working spouses only. Insurers are not obliged to take any individual or category of person.

And what can I do if I cannot add my child to my health insurance policy and I cannot afford to open a separate policy?

In such a case, the hospitalization coverage guaranteed by subsidy would take care of some of the cost. Other care is available from the Department of Health Clinics and you would pay out of pocket for any additional expenses. Fortunately, in Bermuda such cases have not been the rule to date.

Jennifer Attride-Stirling is the CEO of the Bermuda Health Council.