Health Insurance

Search this forum for a lot of info.  But the short answer is there are no individual plans offered here.  You can get group plans with a business or from some employers.   

If you own a small business with at least two employees (owners qualify as employees), you can buy a group health insurance policy. I've looked at Elan a few times but their policies are bloated with coverage for things we would never need. Last time I got a quote it was $37,000 a year for my wife and I (63 & 61), both totally healthy with no pre-existing conditions.

Because we have other citizenships besides USA, we've stuck with Cigna Global for expats for several years but they no longer write policies in the territory (they keep renewing us year after year). Their cover is much cheaper, reliable and worldwide but you pay out of pocket and get reimbursed later. However, our very high annual deductible means that I (the business really) pay for almost everything. It's really just a catastrophe policy.

In the VI, there are no easy paths to obtaining health insurance other than throwing lots of money at it. For the first 11 years we lived here, we didn't have any health insurance at all, granted that was a HUGE savings, but risky.

The general population base is so unhealthy and small here that companies don't want to bother because there's no profit in it, which I understand completely.

Caribbean Risk Group Brings Individual Health Insurance to U.S. Virgin Islands

I’m curious to know what the rates arr fee e like if anyone reaches out.  

@stjohnjulie 

I filled out a Caribbean Risk Group individual health insurance application yesterday.

I haven't heard back from them as yet but will advise the forum when I get a response.

If its anything like the experience I had with Elan, I'll stick with Cigna Global.

So, I put in an application for my wife and I (64 & 61) and was honest about my pre-existing condition. In typical USVI fashion, they were happy to provide coverage EXCLUDING my pre-existing condition! When I questioned how they can exclude pre-existing conditions, she advised that the US Territories (including the USVI) are not part of the Affordable Care Act. As a result, underwriters can underwrite and exclude conditions and attached the letter from the Federal Dept of HHS which clarifies this.

As far as costs for their lower tier "Essential" Plan, it was as follows (includes VI Tax):

>No Deductible: $18,751

>$1000 Deductible: $15,021

>$2000 Deductible: $14090

>$5000 Deductible: $10,361

>$10000 Deductible: $8,497

For comparison, we currently pay $12,800 with a $3000 Deductible from Cigna Global for a very similar level of coverage. So, the Caribbean Risk Group coverage is actually competitively priced.

I've attached the Policy Handbook and Table Of Benefits and for the three plan levels offered for those who are interested.

@vicanuck Thank you!

Prices for health insurance are insane. I assume this is pp in the group. Exclusion of preexisting conditions leaves the door for insurance co to deny coverage. Say you have high blood pressure and u have a heart attack down the road. Chances are you will not be covered for heart issues at all. 

Posted by: @STTsailor

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I assume this is pp in the group.

The quote was for the two of us. But, yes, still outrageous. We're excited to be so close to Medicare so we can reduce our overall healthcare costs. And, my pre-existing condition is an inexpensive, relatively common cancer that's easily treated. So far, I've paid for all treatments and diagnostics out of pocket due to our rather high deductible and look forward to going to FLL for check ups as a mini vacation.

@vicanuck thank you. I had heard a new carrier was coming to the island. This is very helpful.

MAYBE READ*****

New Insurance Provider Offering Individual Options to Virgin Islanders | St. Thomas Source (stthomassource.com)

It's official now 😀 

Lt. Governor Officially Announces Individual Health Insurance Provider in USVI

There really is no health care in the Virgin Islands. Get insurance that you can use on the mainland. I was declined care by a VI physician while standing in her office bleeding. She told me she doesn’t take Medicare patients - though she’s on my UHC Medicare PPO plan as one of two specialty providers on STX. I got on spirit and flew to FLL. Two months later I’m still in Florida recovering from surgery at Cleveland Clinic Florida. Since VI doc wouldn’t see me I couldn’t get a referral to be flown off island so I’m paying for everything not health care related. VI doc did that intentionally. Doc never came out from behind a partition. Shouted instructions to her front desk worker.

all I did was walk in her office and ask for help.

JFL Emergency room was equally traumatic and unhelpful. They just wanted me to leave. Not sure I will ever psychologically recover. Cleveland clinic docs thought I was going to bleed out and I had to get on a plane to be treated. 

please think hard about moving full time to the VI. Love my home, hate this attitude BS that seems so prevalent even among those who you may depend upon to save your life one day.

there are excellent physicians on STX but they can’t make up for the deficit created by their unethical a$$hole colleagues.

@gators_mom and that is exactly why I had to leave my home of 57 years (at that time) and move to the mainland.

Posted by: @gators_mom

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There really is no health care in the Virgin Islands.

This is so true and one of the main reasons we're leaving the VI within the next few years. That and just being bored with being in the same place for too long.

I just got my wife's quotes back and had two plans quoted.  Essential and Standard.  Standard covers a little more and provides more dollars if you go to the US.  So there is also just a plan with only the USVI.  The USVI plan was extemely cheap, like around 3200/year.  It was for actually their best plan for coverage (Superior).  So if you don't travel, that's a pretty good rate, obviously everyone would be different based on prior conditions and age.  They had the wrong age for my wife, one year off and when corrected it lowered the plan 900 dollars.  So for my wife, 44, essentials was around 4300  and standard for 5800 per year with a 5k deductible.  Deductibles only apply to hospital in patient visits.    Anyways, hope this helps.