What is NHI Bahamas?
NHI Bahamas is a new national health insurance programme for The Bahamas introduced by Government. NHI Bahamas aims to ensure that all legal Bahamian residents – no matter your income, age, island of residence or current health status – can receive affordable and accessible health care.
NHI Bahamas is being rolled out in phases. Bahamians began registering for the National Health Insurance program in January 2016. Enrollment for NHI Bahamas began in 2017 and is ongoing. Beginning in May 2017, Bahamians began receiving primary care services under NHI Bahamas. Most recently, in October 2018, the NHI Authority has a consultation paper on the new way forward for NHI which will pave the way for expanded benefits coverage for the future.
In the first phase of coverage (Primary Care), Bahamians receive a number of health services at no cost at point of care. The full list of benefits can be found here.
Why does the country need National Health Insurance?
We must improve access and affordability of quality health care for our people. Currently, approximately 70% of Bahamians do not have health insurance, meaning they may have to pay for health services out of their own pockets. An average Bahamian household spends approximately $2,300 per year on health care, which is something many people cannot afford. Not being able to afford health care can result in illness and even death. Severe illness can be prevented often with a simple visit to the doctor, health education, and preventive activities. Modernizing our current health care system is essential to improving the health of our population.
Do I have to pay for NHI Bahamas?
Under the current NHI Bahamas programme, all Primary Care services outlined in the benefit’s package are provided to you at no out of pocket cost at the time you access the services.
Is NHI Bahamas available to everyone?
Yes, NHI Bahamas is available to all legal residents of The Bahamas.
How do I enroll in NHI Bahamas?
If you have an NIB Smart Card, you are eligible to enroll in NHI Bahamas. To enroll, you must choose your Primary Care doctor (from the public or private sector).
Under NHI Bahamas, do I have to give up my private health insurance?
No, you do not have to give up your private insurance coverage if you do not want to. Primary Care services, which are covered in under the current programme, are covered by NHI Bahamas and any additional health care services you pay for is a top-up to that coverage.
What is covered under NHI Bahamas?
Under the current programme Primary Care services are covered. This includes, but is not limited to, visits to your doctor (Primary Care Provider), disease prevention, health screening, and some labs.
The full list of Primary Care services covered under the initial phase of NHI Bahamas can be found here.
What is Primary Care?
Primary Care is best described as the wide variety of health services provided to you by a family doctor or other Primary Care physician. Your Primary Care physician guides you through the health care system by referring you to specialists, maintaining relationships with nurses, labs, and other health care stakeholders. Primary Care includes disease prevention and health promotion as well as early diagnosis and treatment of common diseases.
Who is in charge of NHI Bahamas?
The National Health Insurance Authority (NHIA) oversees the implementation of NHI Bahamas for the Government.
How is NHI Bahamas funded/who pays?
Currently, all funding comes from the Government’s general revenue to the NHIA. A new proposal for the NHI programme has been released that proposes a shared funding mechanism between Government, employers and citizens.
Will there ever be a tax for NHI Bahamas?
It is anticipated that a contribution will be needed in the future. Research shows that at least 60% of Bahamians would support a payroll deduction similar to NIB contributions to help pay for NHI Bahamas.
Why has the Government started with Primary Care coverage?
Bahamians greatly benefit from having access at no cost to a Primary Care doctor, who will take responsibility for your care needs. Effective primary health care can address medical needs early and prevent more serious conditions from developing.
Does NHI Bahamas cover expensive treatments for diseases such as cancer, HIV/AIDS, and diabetes?
Currently, only treatments for diseases that can be delivered through Primary Care are covered.
How is the health care system going to handle the increased demand for health services when all legal Bahamian residents have access to care?
With NHI Bahamas you can choose a doctor in the public sector or the private sector, a number of persons opt to be seen by a private health provider, creating availability.
Currently, the private health care sector is partnering with public health care providers and participate in NHI Bahamas in addition to the investment the Government of The Bahamas is making to improve the public health care system.
How do I select my doctor? What doctors are part of NHI Bahamas?
Persons who enroll in NHI Bahamas can choose any doctor that is registered and who has capacity to take on new patients. The full list of physicians can be found here.
Do I have to change doctors?
If your current doctor has registered as a provider under NHI Bahamas, you will not have to switch. If you wish to remain with your doctor, but they are not registered, you will either need supplemental insurance or you will need to pay out of pocket for care. Alternately, you can also switch to a doctor that is certified under NHI Bahamas. These choices are up to you.
Does NHI Bahamas cover vision and dental care?
NHI Bahamas does not cover vision or dental care. You would need private insurance coverage for these services, or you would have to cover the cost yourself.
How does NHI Bahamas impact my maternity cost currently provided by NIB?
There is no impact. The NIB continues to manage maternity benefit in terms of cash subsidy. NHI Bahamas covers prenatal care services under the first phase of Primary Care services.
Does NHI Bahamas cover children, the elderly, people with disabilities and those with pre-existing health conditions?
Yes, all legal residents of The Bahamas are covered under NHI Bahamas. No one is excluded because of a pre-existing health condition, age or income.
Will NHI Bahamas protect me when traveling abroad and an emergency medical treatment is required?
No. Bahamians outside of the country are not covered. It is recommended that Bahamians travelling abroad purchase travel health insurance.
Will students studying abroad be able to use the NHI Bahamas coverage with hospitals abroad?
No. Bahamians outside of the country are not covered. It is recommended that a separate policy for students studying abroad be purchased.
Do I need two separate cards for NHI Bahamas and NIB?
No, the NIB Smart Card is all you need to enroll and then access services. You do not need an additional card.
Once I have my NIB Smart Card can I go see my doctor for free?
Once you have your NIB Smart Card, you will then need to enroll in NHI Bahamas and select your Primary Care doctor before you can start accessing Primary Care services at no cost at point of service. The full enrollment process is outlined here.
What is a capitation rate?
Capitation represents a payment to a health care provider on an annual per person basis, rather than a payment for the individual services provided each visit. A capitation rate ensures medical providers are compensated on a per patient basis as opposed to a per service basis.
Is there geographic zoning for patient enrollment?
No, patients are free to choose any provider of their choice, however, NHI will not cover the costs of transportation for patients to visit their providers.
Can a patient register for multiple Primary Care Providers? (for example a provider on the family island and another in New Providence)
A patient will only be allowed to select one Primary Care Provider. You can change your doctor once per year.
How many patients can be enrollled with a PHC physician?
The panel size of each PHC physician in a certified facility is determined based on his/her time commitment to that facility as well as other factors such as the support staff available in that facility.
Can a physician choose his/her patients?
No. Physicians are allowed to set their desired panel size (as long as it is less than the permitted number of patients). The patients will then choose their PHC physician. If a physician has a grievance with a patient, he/she may petition NHI to remove a patient from the empaneled list.