Sagicor Life Jamaica yesterday announced that changes in the administration of its swipe machine system could result in clients spending more out of their pockets for each doctor visit.

In an emailed notice to clients yesterday, Sagicor reasoned that it has been receiving feedback from clients and their members over the past month regarding increased out of pocket expenses for doctor visits.

The life insurance company added that with recent industry wide changes in the administration of the electronic claims submission (swipe machine system), medical doctors, which were once exempted from a transaction fees per swipe, are now required to pay a small percentage of the approved benefit amount.

The administration of the electronic claim submission system is provided by a third party. Upon until January 2018, the administrative service fee which was calculated on a per transaction or per swipe basis was borne by all medical services providers with the exception of medical doctors.

Sagicor noted that after extensive dialogue between industry and all providers, the decision was made to regularise the treatment of fees to include the medical doctors. Its unclear if the system changes has affected clients on Guardian Life’s health insurance.

“We anticipate that this change will, at least partially, be reflected in the doctor’s fees, as it now become a cost of doing business. If your doctor’s visit benefit is $3,000, the additional cost to the physician for the transaction fee will $61.17,” the company said.

“Nonetheless, while out of pocket expenses have been impacted, an electronic method for claims submission at the point of receiving services represents significant value by providing on the spot confirmation of benefits available to each member and allowing for patients to immediately take advantage of the benefit.

“Sagicor is committed to providing efficient administration of medical benefits and thanks you for your feedback,” the notice continued.

Typical of the Caribbean, Jamaica has both a large public sector and large private health sector. Since the introduction of the no user policy in 2008, the country’s public health system is nearly entirely funded by taxes which support hospital, public health and regulatory/stewardship services, and health centres.

With the exception of National Health Fund (NHF) there is no subsidy for large out-of-pocket payments, including inpatient care, drugs, diagnostics, ambulatory and overseas care levied on the private sector.

A study conducted by the NHF in 2009 showed that 56 per cent of health services were financed by the government, another 11 per cent through private insurance and 32 per cent of finances were paid out of pocket.

The study also revealed that while there was a clear preference for the private sector as it relates to ambulatory care (visits to private doctors and specialists) and pharmaceutical services, more than one per cent of all households had to spend half or more of their full monthly capacity on healthcare.