Every beneficiary is required to register at the Medical Benefits Office by presenting a passport or an original birth certificate and Social Security Card.
A beneficiary who seeks refunds for medical services is required to apply at the Medical Benefits Scheme by presenting his/her Medical Benefits Card and original receipts from the place(s) of issue. Applications are made at the Front desk at the Medical Benefits Scheme office.
Employers are liable for payment of contributions on all reported earnings. The Medical Benefits Scheme calculates on earnings received and assumes that only insurable earnings are reported.
No. Each beneficiary is entitled to hold his/her card to obtain benefits.
Yes. Every beneficiary is required to have a social security card when applying for a Medical Benefits Card also an original birth certificate or passport.
There are four categories of beneficiaries:
- a person who has paid medical benefits contributions for 26 weeks in any calendar year, or any period of 12 months
- a person certified by a medical practitioner to be suffering from any of the specified diseases
- a person who is rendered incapable to work by virtue of age
- a person who is under 16 years.
Beneficiaries are also categorized in two(2) groups:
Group I which include categories -- i), iii) and iv)
Group II which include category -- ii)
(All age-exempted persons must be born in Antigua, or ordinarily resident in Antigua.)
Persons in Group I are entitled to free X-rays, laboratory tests and electro-cardiogram conducted at the Holberton Hospital. Where this treatment is not available at the hospital, beneficiaries are allowed to claim the costs incurred. However, if the beneficiary elects to receive the treatment from a third party provider instead of through the hospital, the amounts reimbursed are limited to the free charged at the hospital.
Those persons suffering from specified diseases are entitled to free medical benefits , including drugs, X-rays, laboratory tests, and electro-cardiogram and similar services.
For hospitalized beneficiaries, all persons(i.e., Group I and II)hospitalized for any disease and treated in the general ward of the hospital are entitled to free medical services, including hospitalization, medical and surgical care and services, drugs, X-rays, laboratory tests, and electro-cardiograms and similar services.
Illnesses covered by Medical Benefits Scheme includes:
- Cardiovascular Diseases
- Diabetes
- Hypertension
- Cancer
- Sickle cell Anemia
- Leprosy
- Certified Lunacy
- Glaucoma
- Asthma
Only Insurable Earnings are to be reported to the Medical Benefits Scheme.
Insurable Earnings include:
- overtime payments
- cost of living bonus
- additional payments for dependents
- supplements for long service industry or efficiency
- commission or profit on sales
- gratuities paid by the employer
- payment for the night or shift work
- production bonus
- danger or dirt money or similar payments
- service charges
- any employee's liabilities(including tax)paid on his/her behalf by employer
- holiday pay or other amounts set aside out of the employed person's remuneration throughout the year or part of the year to be paid to him or her periodically.
Non-Insurable Earnings are earnings that should NOT be reported to the Medical Benefits Scheme.
Maternity allowance is paid weekly. The cheque may be mailed to the claimant's address, be collected at the Social Security Office, be paid to a bank account or be paid to a person whom the claimant has nominated.
Non-Insurable Earnings include:
- Sick Leave
- Maternity Leave
- Severance Pay
- Traveling Allowance
- Meal Allowance
