Yes. If you live in the Cayman Islands, the law says you must have health insurance at least at the level of the Standard Health Insurance Contract (SHIC), bought from an approved insurer. If you are employed, your employer must arrange and pay for that cover, but may deduct up to 50% of your standard premium from your pay, plus the cost of covering your dependants.
This guide explains the Cayman Islands health insurance law in plain terms: what SHIC covers, what employers must do, who CINICO insures, options for the self-employed, losing your job, overseas treatment, visitors, penalties and how to complain. For a wider look at hospitals and the health system, see our guide to Cayman Islands healthcare for expats.
Is health insurance mandatory in Cayman?
Under section 5(1) of the Health Insurance Act (2021 Revision), every person resident in the Cayman Islands must take out a SHIC for themselves and their dependants. You do not need to buy your own policy if you are:
- already covered by an employer's contract
- covered by Government, or given medical services by Government under the Personnel Regulations
- treated by the law as uninsurable (explained further down)
Only approved insurers may issue health insurance covering people resident in the Islands (section 4). If you are moving from abroad, the Health Insurance Commission (HIC) says you may keep your overseas policy, but while you live in Cayman you must also hold cover from a locally approved insurer at least at SHIC level. That second policy is worth building into your budget, and our cost of moving to Cayman calculator can help you plan.
What is the Standard Health Insurance Contract (SHIC)?
The SHIC is the legal minimum: a contract of prescribed health care benefits set out in the Health Insurance Regulations (2017 Revision). Every approved insurer sells it. Many employers offer richer plans, but anything below SHIC level does not meet the law.
What does SHIC cover?
What does SHIC not cover?
Exclusions include infertility treatment such as IVF, sterilisation, and pre-existing conditions that were not fully disclosed in writing. When applying for SHIC, the HIC says you only need to disclose conditions from the last 12 months, including treatment given or recommended and medication taken or prescribed.
Why might I still get a bill?
Doctors and facilities must verify your benefits and submit claims to your insurer within 180 days. You pay any deductibles, coinsurance and charges above the Standard Health Insurance Fees (SHIF) schedule, which the HIC maintains. Providers may charge more than SHIF, but insurers only have to pay the SHIF amount, so it is sensible to ask about costs before treatment.
How much does SHIC cost per month?
The HIC FAQ gives the standard SHIC premium as approximately CI$167 per month, but that figure is undated. Insurers can apply to the Commission to charge high-risk people (those with pre-existing conditions) more; the FAQ gives CI$501 a month as an example.
In June 2026, the Cayman Compass reported that CG BritCay (Coralisle Medical Company Ltd.) proposed a roughly 25% increase to its SHIC premiums from 1 July, which it said was the first SHIC rate change since 2013. The Ministry of Health and the Department of Health Regulatory Services said they were reviewing it. Insurers must support any proposed increase with claims history, loss ratios and projections, and the HIC may order an adjustment after an inquiry if it finds a rate excessive or unreasonable. We could not confirm the outcome, so ask insurers directly for current prices.
Does my employer have to pay for my health insurance in Cayman?
Yes. Section 5(2) requires every employer to take out and keep in force a SHIC for themselves, their own dependants, each employee and each employee's dependants. The HIC puts it this way: employers must provide health insurance for all employees, each employee's unemployed spouse and any dependent children who live in the Cayman Islands, from an approved insurer.
Cover starts on your first day of employment. There is no waiting period, even during probation. If you are weighing up jobs in the Cayman Islands or waiting on a permit (see our guide to the work permit backlog in 2026), it helps to know this from the start.
How much of the premium can my employer deduct from my salary?
Under section 7, your employer pays the full SHIC premium for you but may recover from your pay an amount not exceeding fifty per cent of it. So 50% is the legal maximum, and an employer may deduct less. If you are classed as high risk, the employer may also recover the difference between the higher premium and the standard premium.
Dependants work differently. Section 8 makes the employer liable to pay their premiums but allows the full cost to be deducted from your pay, on top of your own share. The HIC FAQ says the employer is not required to contribute to dependant premiums. Check your contract to see what your employer has agreed.
What must my employer give me in writing?
Within 15 days of starting work, your employer must give you a written statement showing the approved insurer's name and address, the date your cover starts and the contract's insurance number (section 11). Keep it with your payslips.
What can my employer not do?
- Pay you the premium instead of the insurer. The HIC says this is not acceptable, because the employer stays liable.
- Deduct premiums and not pass them on. That is an unlawful deduction, and the HIC says you should file a complaint.
- Let cover lapse. If an employer fails to keep SHIC in place, it is responsible for uninsured medical expenses you would have been entitled to. Under section 12 you can recover the loss from the employer in a court of summary jurisdiction.
Does Cayman health insurance cover my spouse and children?
It depends on whether they count as dependants under the Act. A dependant is:
- a child of the insured person under 18
- an unemployed spouse or unemployed civil partner
- a dependent offspring: someone aged 18 to under 30 who relies on you financially for shelter or care, or someone 18 or over who relies on you for medical or physical reasons
Grandchildren are excluded unless adopted or fostered. A spouse must be a legal resident, and this includes a legal husband, wife or civil partner, or a partner who has lived with you as a spouse in the same household for a continuous five years. An unemployed spouse must not be an employer or employee, must live in the Islands, and can be retired.
What if we both work?
Under section 5(7), spouses working for different employers may choose, with their employers' agreement, whether one employer insures both of them or each is insured separately. Section 5(11) says your children must be covered under only one contract, which you choose.
Who is covered by CINICO?
The Cayman Islands National Insurance Company (CINICO) is a government-owned insurer founded in 2004. Its main purpose is to insure civil servants, pensioners, seafarers, veterans and their families, and it also insures many Statutory Authorities and Government Companies. It administers health benefits for indigent residents and for people who struggle to get cover because of pre-existing conditions.
Can anyone buy CINICO cover?
According to CINICO's health policy page, its Standard Health Plan (SHIC) is open to any legal resident, as Individual, Couple or Family cover, and children over 18 and under 30 can be added as dependent offspring. Applicants are subject to individual risk rating. On its Standard Health Plan page, CINICO says premiums are due on the 1st of each month, policies end if premiums are not paid within 30 days, and reactivation costs KYD 200 the first time and KYD 300 each time after.
Seafarers, veterans and civil servants
The Seafarers and Veterans plan is run on behalf of the Ministry of Health. Eligibility is decided by the Cayman Islands Seafarers Association, the Veterans and Seaman Society of Cayman Brac & Little Cayman and the Cayman Islands Veterans Association.
The civil servants and pensioners plan has a CI$5 million lifetime maximum, pays 100% for in-network Health Services Authority care and gives no coverage for on-island or overseas providers used without a referral. CINICO's SHIC plan packet also says local or overseas out-of-network care without approval from the Chief Medical Officer will not be covered under any plan.
CINICO's head office is at Maiden Place, Elgin Avenue, George Town (1-345-949-8101, Monday to Friday, 9am to 4pm). There is also an office at #20 Kirkconnell Building, Kirkconnell Street, Stake Bay, Cayman Brac; check current hours with CINICO.
Which insurers sell health insurance in Cayman?
The HIC lists these approved insurers. The list can change, so confirm it with the Commission, and check each insurer's own website for current contact details.
- Aetna Life & Casualty
- BAF Insurance Company (Cayman) Ltd.
- Cayman First Insurance Company Ltd.
- CINICO
- Coral Isle Medical Insurance
- Guardian Life of the Caribbean
- Pan American Life Insurance Group
- Cayman Integrated Healthcare
- Island Heritage Insurance
Can I buy a top-up plan?
Yes. Section 13 lets anyone buy voluntary supplemental health insurance from an approved insurer in addition to SHIC. Be aware that for supplemental plans the insurer can review your full medical history, not just the last 12 months.
Health insurance for self-employed people in Cayman
Section 5(14) applies the duty to be insured to every self-employed person and treats every partner in a partnership as self-employed. The HIC says self-employed people must buy their own cover from an approved insurer, and their unemployed spouse and dependent children should also be covered.
What if I cannot afford cover or an insurer refuses me?
The HIC says people who cannot afford health insurance can apply to the Department of Financial Assistance to see if they qualify for help. Under the Act, Government may also insure people the Minister deems indigent, on the advice of the Director of the Department of Children and Family Services.
It is unlawful for an approved insurer to refuse SHIC cover. If a person's risk is excessive, the insurer may apply to the Commission. If the Commission certifies the person as uninsurable, they become eligible for cover with an insurer the Commission designates, or possibly for assistance through Children and Family Services.
What happens to my health insurance if I lose my job?
The HIC says cover ends on the first day of the following month. If you remain resident and are not insured by another employer, you can ask your former employer to continue your cover for up to three months, paying the full premium yourself. After that, the individual duty to be insured still applies, so arrange your own policy.
Does Cayman health insurance cover treatment overseas?
Under SHIC, in-patient treatment overseas is claimable only if two registered medical practitioners confirm in writing that it cannot be provided in the Islands and your insurer gives prior written consent (regulation 3(3)). SHIC also includes air ambulance for life- or limb-threatening emergencies at 100% up to CI$15,000 a year. Plans above SHIC level have their own rules, so read your policy and get approval before you travel for care.
Do visitors need travel insurance for the Cayman Islands?
The Health Insurance Act's duty applies to people resident in the Islands. We found no official Cayman source saying visitors must hold travel or medical insurance, so check current entry requirements with Customs & Border Control or the Department of Tourism before you travel. Buying travel insurance that includes medical cover is still a sensible precaution. The HIC notes that residents applying to Customs & Border Control for an extension must keep their health insurance and show proof of active cover on the application. In an emergency, call 911.
What are the penalties for not having health insurance in Cayman?
The Act sets court fines, while the HIC can also use smaller administrative fines.
How do I complain to the Health Insurance Commission in Cayman?
The Health Insurance Commission, part of the Department of Health Regulatory Services, regulates the industry. It monitors premium rates and approved insurers, runs the Segregated Insurance Fund, maintains the SHIF schedule and resolves complaints. You can:
- email hic@gov.ky
- call +1 (345) 946-2084
- use the Complaint Intake Form or the Notification of no insurance form on the HIC page
Have your payslips, your employer's written statement and any insurer letters ready.
Are these rules still current?
This guide uses the Health Insurance Act (2021 Revision, revised as at 31 December 2020) and the Health Insurance Regulations (2017 Revision), the latest versions linked from the HIC page in October 2026. Later amendments may exist, and premiums and insurer lists change, so confirm anything important with the Health Insurance Commission before you rely on it.
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