Expert: Drew Wilmoth - 11/18/2008

Question
Hello,

I have a job offer on one of the sister islands, but I am not sure about their medical coverage yet.  I understand that they are required to pay 50%, but I have a pre-existing condition which involves very expensive medication.  Would this medication be covered through my work insurance or would I have to pay for all of it?

As well, there is a medical questionnaire that I need to fill out.  Will i be declined a work permit because I have an auto-immune disease?

Thank you.

Answer
Employers are required to effect coverage for employees, as well as the employee's uninsured spouse and minor children who are also living in the Cayman Islands. The employer must pay the entire premium to the insurer. The employer may then recover by payroll deduction no more than 50% of the cost of the employee's insurance. The employer may recover 100% of the cost of insurance for the employee's spouse and minor children.

The minimum level of insurance coverage is defined in the Standard Health Insurance Contract 1. It is fairly basic with limits of CI$25,000 per incident, up to CI$100,00 per year with a CI$1,000,000 lifetime maximum. To the best I can determine, prescription drug coverage is not mandated under this policy unless it is medication administered during the course of an inpatient hospital stay. Additionally pre-existing conditions may be completely excluded.

The employer may offer insurance with terms which are more favorable to the employee. Their plan may cover pre-existing conditions and may cover prescription drugs. The employer may pay more than 50% of your premium, and the employer may pay some portion of the premium for any dependents.

So whether the medication for your pre-existing condition would be covered is something that you must investigate with the insurer of your potential employer. It would depend upon the exact policy in force and whether or not pre-existing conditions are excluded.

Work permit issuance is dependent upon a medical exam with the government looking to exclude those whose medical care may become a financial burden on the government as well as those who present a public health hazard.

An auto-immune disorder would not normally be expected to present a public health hazard as such conditions are not contagious. Whether the costs of treatment for your condition would make you a potential financial burden on the government would be a consideration. That would depend upon the exact nature of your condition and the treatment costs.