Matters in Healthcare: Are physiotherapy or nutritional counselling covered?

FRIDAY, OCT. 26:

Answers supplied by: Jennifer Attride-Stirling

I know I can visit my doctor and my health insurance will cover the cost, but what if I need to visit a physiotherapist or get nutritional counselling?

This depends on your health insurance policy. Most comprehensive policies include a set number of allied health visits for things like physiotherapy and nutritional counselling. But the law doesn’t require health policies to cover these, so insurers include it in some policies but not others. Policies described as basic or having less than major medical coverage tend to exclude some benefits, and allied health may be among them.

What all insurance policies have to include by law is hospitalization cover or what is called the Standard Hospital Benefit. This is because, anywhere in the world, hospitalization is the most resource-intensive and costly care, so the coverage is mandated to ensure persons with insurance are protected for the most catastrophic health events and largest financial risks. So, before you plan a visit to a physiotherapist or other allied health professionals, contact your health insurer to understand what will be covered by your policy.

My optician tried to charge me for my glasses even though I have health insurance and I have been told of others being charged for their hearing aids. I thought with the ban of upfront payments I could not be charged the full price?

Effective August 1st 2012, the Health Insurance (Health Service Providers) (Claims) Regulations 2012, did prohibit charging insured patients for the insured portion of a health bill at the time of service (upfront payment). 

However, medical appliances, devices and products, like glasses, crowns, etc., which may be covered by health insurance are excluded from the Regulations. This is because medical appliances are products that have to be custom-made for each patient and ordered from overseas labs. If healthcare providers had to absorb the cost upfront and a patient didn’t return for the product, the provider would be left out of pocket. Therefore, the law allows for patients to be charged upfront for these.

For more information about the Regulations visit our Health Insurance page on our website www.bhec.bm.

The cost of my health insurance is too much. Can I get my health insurance from an insurer in the US, for example?

If you are an employer in Bermuda the Health Insurance Act 1970 requires that you provide insurance from a “licensed insurer” to your employees and their unemployed spouses.

The Act also requires self-employed persons to acquire health insurance from a “licensed insurer”. Overseas insurers are not licensed in Bermuda.

As an individual there is no legal mandate to purchase insurance and, therefore, there are no local legal limitations on where you may purchase it.

Jennifer Attride-Stirling is the CEO of the Bermuda Health Council.