Funding for kidney transplants will be increased to $100,000 while general outpatients can claim $500 a year towards their treatment, under additional benefits to Government's Health Insurance Plan.

Health Minister Nelson Bascome announced the new measures yesterday, following a review of HIP by the Bermuda Health Council. They will be funded by the Health Insurance Fund (HIF) at a cost of $2 million, but at no extra cost to policy-holders.

Mr. Bascome said the additional benefits will take place from August 1, "without increasing the premium that is paid by our HIP policy-holders".

"The intent of these additional benefits will be to provide access to additional key healthcare services that are not presently covered by HIP," he said.

Permanent Secretary of Health, Warren Jones, said: "Based on our estimations, the Health Insurance Fund can support the additional benefits without raising the premium for HIP policy-holders. The cost to the HIF will be approximately $2 million."

Under the new benefits, HIP will provide $70,000 towards a kidney transplant – adding to the current $30,000 paid by the Mutual Reinsurance Fund (MRF).

"HIP will provide an additional $70,000 making the total benefit for a kidney transplant $100,000," said Mr. Bascome.

Policy-holders will also get $500 a year towards costs to see specialists, such as outpatients or visitors to a doctor's surgery.

Mr. Bascome said: "Our policy-holders will be aware that HIP does not cover the cost of specialist visits which occur within a doctor's offices or during outpatient visits to KEMH.

"Should they require a visit to an internal medicine physician, eye surgery or attend the bone fracture clinic at KEMH as an outpatient, they have had to pay those costs out-of-pocket.

"The new benefit will provide coverage of up to $500 to be applied to these types of specialist services and others for medically-approved procedures."

He added: "We are presently defining the scope of this benefit so that policy-holders and physicians will be clear on what constitutes a 'medically-approved procedure' and what will be funded by HIP."

In addition, Government is to introduce basic dental cover under the insurance plan.

The Minister said: "Access to dental services is a critical need for many of our seniors. We recognise this need and are presently defining the scope of this benefit so that both the dentists and the clients are clear on what procedures will or will not be covered by the plan."

Mr. Bascome told The Royal Gazette this would cover "cleaning practices (hygiene) and filling practices – basic dental care".

He said: "HIP started as a basic insurance product when it was conceived. Recent years have clearly shown us that its role has become far more aligned with the social needs of our community. Therefore, we have amended the benefits to be closer to the needs of those that are most needing of the services.

"The obvious question that arises is why introduce these benefits with FutureCare on the horizon? Simple – our seniors need access to these services now."

Mr. Bascome said the summer start-date would allow time to "develop, consult and communicate the scope of the dental and specialist components of this initiative."

Government is to release more information to the public ahead of the implementation date.

The Minister also said Government aims to clear the backlog of HIP payment reimbursements by July. Commenting on delays in the paperwork, he said: "There have been a number of improvements, and we have been working on those issues for the past couple of months. We're looking at July by the date we are looking to have all of our backlog cleared."

Permanent Secretary of Health, Warren Jones, added that Government would shortly announce a contractor for the "long-term" computer automation of the service, which would speed up payments.

He said: "We have received proposals and are going through that process right now of determining that. I think it would be (announced) within the next couple of months."

A year ago, The Royal Gazette revealed that at least four doctors' practices had pulled out of the insurance programme and were demanding patients pay upfront due to delays of up to two years in reimbursement of services.

In January, Mr. Jones said more staff were being hired but that it would take computer automation of the plan to make payments within a month.

Last year, Government's Information Technology Office (ITO) requested proposals for software to implement the claims automation for the Department of Social Insurance. An interim solution - Spy Glass is currently being used until a long-term contractor is chosen.

HIP is the standard health plan offered by Government under the Hospital Insurance Act 1970, and is overseen by the Hospitals Insurance Commission and the Minister of Health. It costs approximately $202.28 every month for someone under-65 and $201.50 for seniors - premiums can be taken directly out of their pension.

More than 5,250 people are policy-holders with up to 135,000 claims made each year.

The Health Insurance Plan Additional Benefits Order 2008 are published in detail in today's Official Gazette.