ELIGIBILITY

The Sagicare Credit Unions provides both Individual and Family Coverage.

COVERAGE

Individual Coverage

You may apply for coverage if you are between 18 and 69 years of age. If you are an existing Sagicor subscriber through your Credit Union, your coverage will continue beyond age 70, provided you continue to pay your premiums.

Family Coverage

You may opt for coverage for your spouse (married or unmarried), and/or dependent children - biological or adopted, up to nineteen years of age. Children aged nineteen to twenty-two years of age may be covered provided they are enrolled at a tertiary institution as a full time student*.

BENEFITS

The plan offers you four benefit options which cover:

• Hospital Room and Board
• Hospital Outpatient Services
• Private Nurse
• Surgical Fees
• Maternity (on Individual and Family Plans)
• Consultation Fees
• Doctor's Office Visits
• Major Medical
• Diagnostics
• Physiotherapy
• Prescription Drugs, Dental and Optical
• Overseas Non-Emergency Coverage
• Overseas Emergency Coverage

HOW TO ENROLL

• Complete and sign a Sagicor Application/Enrolment Card.
• Return the Completed Application Card to your Credit Union with a minimum of two (2) months' premium.
• On receipt of your application, Sagicor will prepare a Membership Card, which will be delivered to you through your Credit Union. The card will be valid until the end of the policy year and may be renewed annually.
• If you are on an Individual Plan, you may transfer to Family Membership at anytime during the year. Any stipulated waiting period will commence from the effective date of the transfer.
• Newborn and legally adopted children to be covered under your plan, must be registered with the plan within 90 days of birth or adoption, whichever is applicable.
• All enrolment transactions are channeled through your Credit Union.

PREMIUMS

Your premiums are due on the date stated in your contract and must be paid by the date specified by your Credit Union. To avoid cancellation of your Health Policy ensure that your premiums are paid to your Credit Union on time.

WAITING PERIODS

Waiting periods apply in respect of the following conditions:

• Pregnancy
  Nine (9) months for maternity benefits and benefits for any condition related to pregnancy.
• Pre-existing medical and surgical conditions
  Six (6) months for such conditions, whether known or unknown.
• Hospitalization and services which go into Major Medical
  Six (6) months.
• Change of spouse
  This is done only on the anniversary date of the contract or where marriage has taken place.

HOW TO ACCESS BENEFITS

Once your premiums have been accepted at the Sagicor Office, you are eligible for immediate benefits, except for situations where waiting periods apply. To access benefits, you must show your Sagicor Membership Card to the provider - doctor, pharmacy, laboratory or diagnostic service.

CLAIMS

• You must submit claims within 90 days or service. Sagicor reserves the right to deny payment of claims submitted after 90 days
• You must affix your membership number, and correct name and address as failure to do this will result in your claim not being processed
.
• You should also state your Sagicor number on all correspondence you send to Sagicor, or if you call the office with a query.

* - Conditions Apply