Hospital patients will be required to pay upfront for prescriptions

Policy aims to help HSA payment collections

Patients at the Cayman Islands Hospital’s pharmacy will be asked to pay upfront for their prescriptions from January next year. 

The policy change is part of a wider effort from the Health Services Authority to improve collection of payments. The HSA was highlighted in a recent auditor general’s report for writing off tens of millions of dollars in unpaid debts over the past decade. 

Jonathan Tibbetts, chairman of the authority board, said it was phasing in a new policy of requiring upfront payments in various departments. 

“The policy has already been working well for elective surgeries in the Operating Theatre and will be phased in across the HSA,” he said. 

Lizzette Yearwood, CEO of the authority, said the changes were necessary to ensure adequate funding for healthcare. 

“Like every other healthcare provider in the world, the HSA is facing significant challenges in regards to the cost of providing healthcare. Full implementation of our Payment Policy is critical to continued funding of our operations,” she said. 

“Provision of healthcare is dependent on adequate levels of funding. Improving our collections will allow us to broaden our scope of services and expand our facilities. With this policy, we are calling on all residents to do their part and help us help everyone in our community,” he said. 

She said funding through the Needs Assessment Unit may be available to patients struggling to find the funds for prescriptions. 

Ms. Yearwood said the authority’s bad debts were being driven by a small section of the population that remained uninsured or underinsured, 15 years after the Cayman Islands switched from a national healthcare system to an insurance based system. 

“Our community is taking some time to adjust to the insurance based model which was put in place in 2000. In the old model, care was provided to the population by the Government’s then Health Services Department which was funded by General Revenue. With the implementation of the Health Insurance Law everyone is required to have health insurance, however, there still remains a portion of our population that is uninsured or underinsured. This is our self-pay population which continues to drive our bad debt.” 

The pick-up window at the pharmacy in Cayman Islands Hospital. From January next year, patients will be required to pay for prescriptions upfront. - Photo: Kelsey Jukam
The pick-up window at the pharmacy in Cayman Islands Hospital. From January next year, patients will be required to pay for prescriptions upfront. – Photo: Kelsey Jukam


  1. I believe the immigration department need to look seriously into persons living on the island without no insurance and or pension. Many persons are legally here by being married to a Caymanian or other attachments to Cayman; however seventy five percent of them; ARE WORKING and does not have Insurance or pension because they do not need a work permit. They pay NO INSURANCE and NO PENSION flying under the Radar.
    When an emergency take place, like an accident or they have to be taken to the hospital, what then?
    These persons need to be monitored when leaving or returning to the island, their PR with Right to work should come into question about their insurance and pension payments, after all the spouse or other family member should not be responsible for this.