The group should consist of not less than 4 eligible employees working a minimum of 30 hours per week.
Groups of 4-25 persons require 100% participation. All persons are required to have the same benefits unless there are benefits tied to their salaries. Where dental and vision is offered, 100% of the group has to be covered. Groups of 26+ persons require 75% participation.
BahamaHealth individual medical insurance provides coverage for persons ages 0-99. Applications are accepted through age 69.
Completed application form, $90 application fee, 1st month’s premium inclusive of VAT charges, copy of government issued, verified, valid ID, copy of NIB card
There is no waiting period for services unless the medical condition is pre-existing.
This is an illness or injury for which symptoms have been present or for which a member has received medical care, treatment or advice at any time during the 12 months before coverage begins under the policy.
Premiums are payable the first day of the month.
Premium rates are locked in for a year after the start of the policy. Every year on the anniversary of the policy premiums are reviewed and new rates are given for 12 months.
You must complete an Advice of Change form. You can downgrade your plan at any time. You can upgrade during your renewal month only.
Complete an Advice of Change form and provide the updated information.
Reminder notices are generated on the 15th of every month and Pending Suspension notices are sent on the 25th of every month.
Bills are sent on the first business day of the month and you have until the end of the month to make payments.
Payments can be made over the counter via cash, cheques, or credit cards. Payments can also be made online, through salary deduction, post-dated cheques, or pre-authorized credit cards.
For services you have paid for in full, your medical provider must complete the claim form which you should submit to BahamaHealth together with payment receipts.
Submissions should be forwarded to the Claims Support department by hand or via email: bhclaimsubmission@familyguardian.com
Reimbursement claims are processed within 5-10 working days.
A deductible is the amount you must pay annually towards certain categories of medical expenses before insurance benefits begin.
The out-of-pocket amount is the portion of medical expenses that you are responsible for. Typically, this refers to the combined total of any deductible and co-insurance costs for which you are responsible annually.
A copayment is a flat amount that a member will pay at the time of service. Coinsurance is a percentage of the allowable amount that will be paid by BahamaHealth.
This is the amount that is over the reasonable and customary charges for each service. This amount is not payable by BahamaHealth.
An in-network provider has a contract with BahamaHealth and agrees to accept assignments for services rendered. An out-of-network provider does not have a contract and does not accept assignment of benefits so that payment in full by the patient is required.
You can contact our healthcare coordinators at 242-396-1303.
Pre-certification, also known as pre-authorization, is the process of obtaining BahamaHealth’s approval in advance to receive a particular, covered medical service, subject to eligible charges. Pre-certification is usually required for planned medical procedures such as surgery, hospitalization, MRIs, etc.
BahamaHealth does not require that you obtain a referral to see a specialist. However, the specialist you visit may require a referral from your primary care physician.
The practice of balance billing refers to a physician’s ability to bill patients for outstanding balances after the insurance company pays its portion of the bill. Once a physician is contracted with BahamaHealth, the member should not incur a balance bill.
You can choose to keep your child(ren) on your health insurance policy until they turn 25, subject to their still being in school/college. When your dependent child turns 19, you are required to submit student information in order for them to retain coverage.