PAHO explores more affordable insurance coverage for Jamaicans living with NCDs

The Pan American Health Organization (PAHO) is embarking on a study to determine if insurance providers can offer more affordable coverage to people living non-communicable diseases (NCDs) in Jamaica.

NCDS such as cardiovascular diseases, cancer, diabetes, and chronic lower respiratory diseases are now responsible for between 70 per cent and 75 per cent of all deaths in the country.

Given the significant financial burden that comes with living with non-communicable diseases, the Americas-based health agency says it recognises the need to better understand and address the financial barriers that people managing such health conditions face.

“Beyond the cost of consultations and medication, many individuals require ongoing access to specialist care, diagnostic tests, hospital services, transportation, special dietary needs, medical equipment, and rehabilitation. Over time, these expenses can place considerable pressure on households, forcing some to rely on savings, borrow money or, reduce spending on other necessities,” PAHO shared in a release.

“This challenge is particularly significant as NCDs, including cardiovascular diseases, diabetes, cancer, and mental health disorders, remain among the leading causes of illness and death in Jamaica,” the United Nations agency added.

While Jamaica has made important progress in strengthening prevention and treatment services, many residents continue to face financial barriers in accessing essential care, particularly for screening, diagnosis, treatment, long-term management, and rehabilitation.

PAHO disclosed that it convened the first meeting of a technical working group (TWG) at the Jamaica Country Office on 10 July 2026, to advance Phase II of an assessment examining the adequacy of health insurance coverage for NCD care in Jamaica.

The assessment will examine Jamaica’s current health insurance landscape and explore opportunities to strengthen the role of health insurance in supporting access to NCD prevention, screening, diagnosis, treatment, and long-term management. This review will provide an important opportunity to identify practical, evidence-based options to improve financial protection and promote equitable access to care for people living with, or at risk of, NCDs.

“PAHO/WHO remains committed to supporting Jamaica’s efforts towards Universal Health Coverage and Universal Access to Health, ensuring that all persons can obtain the health services they need without suffering financial hardship. Strengthening financial protection for people living with NCDs is critical to reducing barriers to care and ensuring that access to essential health services is not determined by an individual’s ability to pay,” Ian Stein, PAHO/WHO Representative for Jamaica, Bermuda and the Cayman Islands, stated.

NCDs often require a complex and prolonged cascade of care, starting with prevention and screening and extending through diagnosis, treatment, management, rehabilitation, and, where necessary, palliative care.

When insurance coverage is insufficient, the financial responsibility oftentimes falls on individuals and their families through out-of-pocket payments. Such payments, usually taken from household incomes, reduces the financial resources to meet other essential needs.

As such, PAHO believes that having more affordable health insurance can play an important role in reducing these financial barriers. For people living with chronic diseases, adequate health insurance coverage can help reduce out-of-pocket expenses and protect individuals and families from financial hardship associated with ongoing healthcare needs.

The agency advocates that more affordable insurance can be achieved through pooling resources and it will provide protection against high healthcare costs while improving access to essential services.

As part of the assessment, the working group will review Jamaica’s regulatory and policy environment for public and private health insurance. It will also examine existing private health insurance policies, including coverage conditions, premiums, eligibility requirements, and utilization patterns. The assessment will also explore whether persons diagnosed with pre-existing NCDs faced higher premiums and considered opportunities to expand coverage to reach at-risk and underserved population groups.

“Building on this review, particular attention will be given to the potential contribution of the health insurance industry in supporting earlier detection, treatment, and long-term management of priority NCDs, including hypertension and cardiovascular disease, depression and other mental health disorders, diabetes mellitus type 2, breast cancer, cervical cancer, colorectal cancer, and prostate cancer,” PAHO said.

“Strengthening health insurance coverage requires careful consideration of equity and financial protection. While private and voluntary health insurance arrangements can complement public health financing efforts, appropriate regulation and effective risk pooling mechanisms are important to ensure that access to care is not limited by income or health status,” the body continued.

President of the Insurance Association of Jamaica Rosemarie Henry concurs that an assessment of insurance coverage for NCDS will need to look beyond pricing mechanisms.

“Affordability isn't just about insurers pricing differently; it also requires the legislative tools to make it possible. Jamaica still doesn't have microinsurance legislation in place, despite this being flagged by Government as a priority as far back as 2022,” she told Amber News in an emailed response.

“A proper microinsurance framework would allow insurers to design simplified, lower-cost NCD-related products for the market. This is something the current regulatory structure doesn't easily accommodate,” she continued.

For PAHO, the technical working group meeting provided an opportunity for stakeholders to review progress, share technical guidance, identify potential challenges, and strengthen collaboration in advancing the assessment. The findings and recommendations arising from this assessment will support efforts to strengthen health insurance coverage for NCDs, reduce the financial burden on individuals and families, improve access to essential services, and contribute to broader national discussions on health financing, social protection, and approaches to achieving better health outcomes for the Jamaican population.

-JS