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NHIB’s Statement at the MOH Access to Healthcare Press Conference – June 28, 2022

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#TurksandCaicos, July 16, 2022 – The National Health Insurance Board was established under the National Health Insurance Ordinance 2009, as a statutory body. NHIB’s goal is to facilitate the provision of accessible, affordable, and quality health care services to all its beneficiaries. We would like to use this platform to educate the public on the referral and treatment abroad program and how they work.

Urgent/Non-Urgent Referrals

Urgent referrals are referrals that must be executed within a short period of time usually less than 48 hours, non-urgent referrals or routine referrals are executed over a longer period. As it relates to these urgent referrals it is important for the public to know that:

  1. A referral must be sent from the hospital, through the Joint Referral Committee, to NHIB for processing. You must be seen by a doctor at TCI hospital who will then decide whether your case is eligible for urgent referral.
  2. The Medical Director reviews the referral and will advise the operations department to proceed.
  3. We have an operations team NHIB that checks the eligibility of the beneficiary.
  4. Once a beneficiary is eligible, the transfer arrangement begins.
  5. Referrals are sent firstly to providers in the region (Jamaica, Dominican Republic and Cayman Islands) for acceptance. If the case cannot be managed within the region, then it is sent to our providers in Colombia.
  6. Patient (if able to communicate) or next of kin is contacted and informed that NHIB is in receipt of an overseas referral and what arrangement will be made. The NHIB process is explained during this time.
  7. Once a physician and a hospital accept the case, travel arrangement (air ambulance or charter, commercial flight) will begin.

Treatment Abroad Program

Challenges and Important Information We do face a few challenges with the referral service especially when a patient must be flown out of country for special care. One of the major challenges is travel documents. We are asking the public to make sure your documents are up to do date as you do not know when you or a loved one that you may have to accompany will face sudden health challenges that require medical attention overseas.

  1. NHIB does not pay for travel documents, passport, or visas.
  2. Nationalities that require visas to enter another country is responsible for getting their visa, NHIB only assist with medical visas.
  3. NHIB provides a subsistence to assist with living arrangements and ground transportation. What this means is that we do not cover the cost of your FULL living arrangement while seeking medical treatment abroad. What we do is provide you with a stipend that should assist with your day-to-day expenses.
  4. Medical bills for health procedures abroad are 100% covered by the NHIB (subject to the limitations included in NHI (Benefit) Regulations Section 6(3)). This means that when you travel to get medical attention under the Treatment Abroad Program, you do not receive a bill. Your medical expense is fully covered (see above).
  5. Work Permit holders are reminded that work permits are to be renewed three months prior to expiry. Beneficiaries with an expired work permit cannot be transferred in the event of an emergency.
  6. Some beneficiaries are only entitled to receive on island care.
  7. As it relates to Air Ambulance – This is a service which we source from providers overseas. The closest air ambulance company is in the Dominican Republic, others are based within the United States. Air ambulance confirms their ability to transfer based on availability of aircrafts and medical personnel, the nature of the case, and their capacity to transfer a patient safely.

Understanding Co-payments

We also use this opportunity to advise the public that if you are covered and eligible under the National Health Insurance Plan and you visit a clinic to see a private doctor on island, that $35 is deducted from your bill and paid by NHIB. TCI hospital is our preferred health provider, so once you are eligible, you only pay $10 copayment when seeking medical services covered by NHIP.

Services NOT covered by National Health Insurance Plan

The following are medical services that are NOT covered by the NHIP:  Cosmetic procedures; Long term care; Long term psychiatric care; Orthodontics for adults; Acupuncture; Homeopathy; Alternative medicines; Podiatry; Lifestyle procedures and sex changes; Short term nursing or home skilled nursing facility; Fertility treatments; Dermatology; Dentistry.

Closing Remarks

I would like to take this time to thank all NHIP’s contributors. Once you get a good understanding of the National Health Insurance Plan, you will know that even though you may not require medical attention at this time, someone in need of medication, pre-natal care, emergency treatment, and all that is covered under the NHIP, is able to get the care they need because of your contribution. So, continue to make your contributions, and make them on time to avoid late fee penalties. Let us continue to work together in building a healthy nation one person at a time.

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Government

Government Outlines New Healthcare Vision as Interhealth Exit Accelerates Reform  

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By Magnetic Media Newsroom

 

PROVIDENCIALES, Turks and Caicos Islands — The Turks and Caicos Islands Government says the breakdown of its relationship with InterHealth Canada presents an opportunity to reshape healthcare delivery, with plans to expand local medical services, strengthen primary care and reduce dependence on overseas treatment.

During a national briefing following InterHealth Canada’s notice terminating its hospital contract, Premier Charles Washington Misick acknowledged publicly for the first time that Government and InterHealth had been negotiating an exit from the arrangement for more than a year after what he described as an “irretrievably broken down” relationship.

Despite the contractual dispute, Misick and Health Minister Kyle Knowles stressed that healthcare services will continue uninterrupted during the transition.

“Allow us to do our job,” Knowles appealed, assuring residents that Government is actively managing the transition and safeguarding patient care.

The Premier outlined what amounts to a broader healthcare transformation built around four connected levels of care: strengthened community-based primary healthcare; expanded polyclinic services; enhanced hospital-based secondary care with greater specialist capacity; and overseas tertiary treatment only for cases that cannot be managed locally.

Among the proposals are the long-discussed establishment of intensive care units, expanded use of currently unfinished hospital space, recruitment of more resident specialist physicians and stronger contract management to oversee future healthcare agreements.

Knowles said the new polyclinic model will broaden services available outside the hospitals, including dentistry, ophthalmology, laboratory services, diagnostic imaging, gynaecology and preventative screening, helping to reduce pressure on emergency departments while improving early intervention.

Misick also acknowledged that while the hospital system significantly improved healthcare access after opening in 2010, Government believes further reform is necessary to improve affordability, sustainability and the range of services available within the Turks and Caicos Islands.

The briefing marked the Government’s most comprehensive explanation to date of its plans beyond the InterHealth contract, signalling that officials now see the transition as an opportunity to redesign healthcare delivery rather than simply replace one operator with another.

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Planning for Tomorrow: Why Sustainable Communities Begin with Good Planning

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Turks and Caicos – Every thriving community tells a story long before the first home is built. The placement of roads, the routing of utilities, the protection of natural resources and the provision of schools, healthcare and emergency services are all the result of decisions made through careful planning. While these elements are often taken for granted, they form the foundation of safe, functional and sustainable communities.

As populations grow and communities evolve, planning becomes increasingly important. It helps ensure that development takes place in locations that can support it, that infrastructure keeps pace with demand, and that public services remain accessible to those who depend on them. Good planning also considers the future, creating communities that can adapt to changing needs while preserving the quality of life enjoyed by current and future generations.

Where development occurs without adequate planning, however, the effects can be felt far beyond the boundaries of a single neighbourhood. Roads may be unable to accommodate emergency vehicles, utilities can become overstretched, and environmental resources may come under increasing pressure. Delivering public services in these circumstances often becomes more difficult and more costly, creating challenges that affect entire communities rather than individual properties alone.

For this reason, sustainable development can only emanate from careful planning. It must be ensured that homes, infrastructure and essential services develop together in a coordinated and responsible way. Every planning decision contributes to the broader picture of how communities function, grow and respond to future demands.

Supporting that process requires reliable information. Accurate data helps planners and policymakers understand where growth is occurring, identify emerging needs and make informed decisions about infrastructure, housing and public services. It also strengthens collaboration among government agencies by providing a shared understanding of the challenges and opportunities facing communities.

Within the Turks and Caicos Islands, this collaborative approach is reflected in the work of the Informal Settlements Unit (ISU), which supports a range of initiatives aimed at improving the understanding of informal settlement development. Through activities such as GIS mapping, the Social Needs Assessment Survey and collaboration with partner agencies, the ISU contributes valuable information that helps support evidence-based planning and long-term decision-making.

Strong communities are not built overnight. They are shaped through thoughtful planning, informed decisions and cooperation across government and the wider community. As the Turks and Caicos Islands population continues to grow, maintaining that focus will be essential to creating communities that are safe, resilient and equipped to meet the needs of generations to come.

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Bahamas News

Caught in the Net, Not Accused of Wrongdoing

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What the Attorney General must do now to protect Bahamian exports

Deandrea Hamilton | Editor

NASSAU, Bahamas — The United States’ decision to impose a 12.5 percent tariff on Bahamian exports is about more than higher costs for seafood, rum and other goods entering the American market. It is a warning that The Bahamas must move quickly to strengthen or clarify its legal framework governing forced labour and supply-chain enforcement.

The tariff, which takes effect July 24, is part of a sweeping U.S. trade action affecting 60 economies following a review by the Office of the U.S. Trade Representative (USTR). The review concluded that the listed countries have not adequately prohibited or enforced measures against goods linked to forced labour in global supply chains.

The action follows a recent U.S. Supreme Court ruling that invalidated an earlier series of Trump-era tariffs imposed under emergency powers. In response, the Trump administration shifted to a different legal authority—Section 301 of the Trade Act of 1974—using findings from a U.S. Trade Representative investigation into forced-labour compliance to support a new round of tariffs affecting 60 economies, including The Bahamas.

Importantly, the action does not accuse Bahamian businesses of using forced labour. Instead, it reflects the U.S. view that The Bahamas’ legal or enforcement framework does not yet meet the standard Washington expects.

That distinction matters.

The Attorney General’s Office now has the responsibility to lead the country’s legal response. That begins with determining precisely what concerns the U.S. Trade Representative identified, reviewing whether Bahamian law adequately addresses those concerns and, where necessary, recommending legislative or regulatory changes. If deficiencies exist, legal amendments and stronger enforcement could help position The Bahamas for removal from the tariff list.

The government may also seek formal discussions with U.S. officials while those reforms are undertaken, outlining a clear timetable for compliance and demonstrating that the country is committed to meeting international labour standards.

A Nassau Guardian front-page report on July 24 drew attention to the tariff action, prompting broader questions about why The Bahamas was included among the 60 economies affected by the U.S. trade measure and what steps are now needed to restore full confidence in the country’s trade framework.

For many Bahamians, the immediate concern will be the fisheries sector, one of the country’s largest export industries. Commercial shipments of lobster, conch, fish, crawfish and other products entering the United States could become more expensive because of the additional tariff, potentially affecting exporters’ competitiveness.

The broader lesson is that international trade increasingly depends not only on quality products, but also on strong business relationships and confidence in the legal systems that govern them.

For The Bahamas, this is less a finding of wrongdoing than a reminder that international credibility is earned through modern laws, effective enforcement and trusted partnerships. The challenge now is for the Attorney General’s Office to lead a swift legal review, identify any deficiencies and chart a clear path toward compliance so Bahamian exporters are not burdened any longer than necessary.

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