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Blue Cross® recognized that there were many pensioners who contributed to the health scheme during their working years, but who, on retirement, were too old to receive individual or group health coverage. This led to the Pensioners Plan.
"Blue Cross of Jamaica Ltd. provides administrative claims payment services only and does not assume any financial risk or obligation with respect to claims."
Some of the stipulations of this plan are that the pensioner must have been enrolled in the Group as a Blue Cross® subscriber for five years prior to the date of retirement, and must continue Blue Cross® membership effective immediately from the date of retirement. The employer must contribute to the programme and make this option available to all permanent employees of the company when they retire. In addition, the group must be individually experience rated and rates will be adjusted from year to year on the pooled experience of the employees group and the Pensioners Group. There is also a special home care for persons over 60 years, which aims at reducing hospital stays while providing essential services at home.
ELIGIBILITY
All government pensioners and government employees who are about to retire and will be in receipt of a pension from Central and Local Government Agencies can receive health care benefits under the Government Pensioners Administrative Services Only (GPASO) Health Scheme. These include teachers, police officers, nurses and civil servants. Pensioners of 55 years of age and over and those persons who retired from government employment because of ill health regardless of age at retirement are eligible for health coverage. Coverage also extends to the pensioner's spouse.
Eligible persons will also include retirees of some Statutory Bodies such as the Jamaica Railway Corporation, Social Development Commission, Institute of Jamaica, Jamaica Library Service, Jamaica Agricultural Society, 4H Clubs, Jamaica Tourist Board, National Water Commission and Kingston and St. Andrew Corporation (K.S.A.C.) and Parish Councils.
JOINTLY MONTHLY CONTRIBUTIONS
Blue Cross of Jamaica Limited on behalf of the Government of Jamaica administers the Scheme, which has provided health coverage for pensioners since December 1995.
The Government of Jamaica pays 80% of the monthly contributions while the remaining 20% is deducted from your monthly pension.
HOW TO ENROL
There are two types of enrolment available to pensioners. The family plan provides coverage for the pensioner and his or her spouse while the individual plan covers the pensioner only. Your enrolled spouse is called a dependent.
Enrolment forms are available at all Blue Cross® offices and the Pensioners Association Office. Where necessary, forms will be dispatched to pensioners for completion island-wide. Blue Cross® personnel will visit and enrol eligible pensioners who are incapacitated.
A. Complete the yellow enrolment Card with the correct information.
B. Complete a Pension Deduction Authorization Form
C. Blue Cross of Jamaica will prepare a membership card when the completed enrolment card and Pension Deduction Authorization Form along with payment are received.
HOW TO ACCESS BENEFITS
A membership card showing the amount of benefits, which may be used from December 1 of each year to November 30 of the following year, the end of the contract year, will be sent to your home address. Cards are automatically renewed each year unless the payment of your premium ceases.
The Blue Cross® card gives you access to health services from over 900 Blue Cross® doctors, specialists, dentists, pharmacies, laboratories, opticians and hospitals. Your card must be presented to a Blue Cross® provider when you receive any of the covered health services. You will be asked to make a co-payment.
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