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Important Update:
Effective 1st May 2023, the Texmed Genmed Group Health Insurance Premiums are as follows;
| Members 65 & Under | GenMed Premiums |
| Member only | $260.15 |
| Member & One | $459.80 |
| Member & Family | $695.75 |
| Members 66-99 | GenMed Premiums |
| Retiree Only | $381.15 |
| Retiree & One | $713.90 |
Schedule of Benefits- Effective 01 May 2023
A Schedule of Benefits is a list of the various services covered under a health insurance plan, that outlines the fees associated with each type of health care service covered by your plan. This includes:
- Your deductible and out-of-pocket max amounts.
- Copays and coinsurance for drugs, office visits, procedures, urgent care and emergency services, imaging, labs, equipment, supplies, and other common types of medical services.
Members 65 & Under
| TEXTEL CREDIT UNION CO-OPERATIVE SOCIETY LIMITED | |
| A DIVISION UNDER THE GENMED CREDIT UINON PORTFOLIO | |
| 65 & UNDER | |
| Maximum Three-Year Benefit | $1,000,000.00 |
| Calendar Year Deductible: | |
| Deductible per Person | $750.00 |
| Deductibles per Family (max 2) | $1,500.00 |
| Co-insurance Factor | 75%-25% |
| Pre-Existing condition | $2,500 (1st 24 months) |
| Hospital Daily Room & Board Limit | |
| Overseas (Non-Caricom) | $2,500.00 |
| Locally (Caricom) | $700.00 |
| Maximum no. days per Disability | 31 |
| Co-insurance Factor | 75%-25% |
| Intensive Care Unit | |
| Overseas (Non-Caricom) | $3,000.00 |
| Locally (Caricom) | $1,000.00 |
| Maximum no. days per Disability | 31 |
| Co-insurance | 75%-25% |
| Miscellaneous Hospital Expenses | 75%-25% |
| Surgical Benefit | 75% of UCR |
| Anaesthesia Benefit | 25% of UCR |
| Doctor's Visits Benefit | |
| Office | $200.00 |
| Home | $250.00 |
| Hospital | $250.00 |
| Maximum no. of visits per Day | 1 |
| Maximum No. of visits per Disability | 31 |
| Co-insurance Factor | 75%-25% |
| Specialist Consultant Benefit (Upon Referral) | |
| Office | $300.00 |
| Home/Hospital | $300.00 |
| Maximum no. of visits per Day | 1 |
| Maximum No. of visits per Disability | 10 |
| Co-insurance Factor | 75%-25% |
| Maternity Benefit (Subject to Deductible /No Co-insurance) | |
| Normal Delivery | $5,000.00 |
| Caesarean Section\Extra Uterine Pregnancy(inc. Surgeon, Anaesthetist, R&B; | |
| Misc. Exp) | $8,000.00 |
| Dilation & Curettage\Miscarriage | $2,000.00 |
| Pre-natal (included in Maternity Max.) | $2,000.00 |
| Waiting Period | 10 months |
| Prescribed Drugs Benefit | 75%-25% |
| Diagnostic, X-ray, and Lab Benefits | 75%-25% |
| Psychologist/Psychiatrist Services (Upon Referral) | |
| Maximum per Visit | $200.00 |
| Maximum no. visits per day | 1 |
| Maximum visit per Calendar Year | 20 |
| Co-Insurance Factor | 75%-25% |
| Physiotherapy /Occupational/Speech Therapy(Upon Referral) | 75% up to |
| Maximum per Visit | $150.00 |
| Maximum no. visits per Day | 1 |
| Maximum visit per Calendar Year | 20 |
| Preventative Care Benefits - (Annual Maximum) | $1,000.00 |
| Chiropractic Benefit (Upon Referral) | |
| (The Chiropractor must be a member of the Chiropractic Association of T&T | |
| (CATT) | |
| Maximum per Consultation | $200.00 |
| Maximum no. visits per Day | 1 |
| Maximum per Calendar Year | 20 |
| Co-Insurance Factor | 75%-25% |
| Acupuncture Benefit (Upon Referral) | |
| (Acupuncture shall only be covered when performed by a licensed physician) | |
| Maximum per Consultation | $200.00 |
| Maximum no. visits per Day | 1 |
| Maximum visits per Calendar Year | 20 |
| Co-Insurance Factor | 75%-25% |
| Air Fare Benefit | 75% up to |
| Maximum Benefit | $10,000.00 |
| Maximum No. of trips per Calendar Year | 2 |
| Air Ambulance Benefit | |
| Maximum benefit | US$25,000.00 |
| Maximum No. of trips per Calendar Year | 2 |
| Co-Insurance Factor | 100% |
| Local Ground Ambulance | 100% |
| Internal Lifetime Plan Limits (Not subject to Ded/Co-ins) | |
| Organ Transplants | 50% Major Medical |
| Maximum subject to UCR | |
| Congenital Birth Defects | $250,000.00 |
| Mental/Nervous Disorder | $25,000.00 |
| HIV/AIDS | $50,000.00 |
| Covid 19 & Hospitalization | $150,000.00 |
| Durable Medical Equipment | 75% subject to UCR to a |
| Per Calendar Year | maximum of $20,000.00 |
| Radiotherapy/Chemotherapy/Dialysis | Subject to deductible and |
| Per Calendar Year | co-insurance up to a |
| maximum of $150,000.00 | |
| Repatriation of Mortal Remains | TT$20,000.00 |
| Private Duty Nursing | |
| Maximum per 8 hr. shift - Private Residence -Day | |
| Maximum per 8 hr. shift - Private Residence -Night | $250.00 |
| Maximum per 8 hr. shift - Hospital-Night | |
| Maximum no. of days per disability | 30 |
| Co-Insurance Factor | 75%-25% |
| DENTAL CARE BENEFIT | |
| Maximum Benefits per Calendar Year: | $2,000.00 |
| Deductible per Calendar Year | $150.00 |
| Orthodontic Treatment:( Lifetime Benefit Limited to children up to age 19) | $2,000.00 |
| Orthodontic Treatment Annual Benefit | $1,000.00 |
| Co-Insurance Percentage | 75%-25% |
| Waiting Period | 3 Months |
| VISION CARE BENEFIT | |
| Maximum per Calendar Year | $1,750.00 |
| Deductible per Calendar Year | $150.00 |
| Co-Insurance percentage factor | 75%-25% |
| Contact Lenses (Not medically approved) | Inc. in Vision Max. |
| Waiting Period | 3 Months |
Members 66 to 99
| BENEFITS | GENMED Renewal Benefits |
| Maximum Benefit: | $500,000 |
| Benefit Period | 6 Year Renewal |
| Calendar Year Deductible | $1,000 |
| Deductible per family | $2,000 |
| Co-insurance | 70%-30% |
| Hospital Daily Room and Board Limit | |
| Locally/ Caricom | $500 |
| Overseas (Non Caricom) | $2,500 |
| Intensive Care - Locally/ Caricom | $1,000 |
| Intensive Care - Overseas (Non | |
| Caricom) | $3,000 |
| Miscellaneous Hospital Expense | |
| Benefit Maximum | 70%-30% |
| Surgical Benefit | |
| Disability Maximum | 70% of R&C charges |
| Anaesthesia Benefit | 25% of Surgical R&C |
| Doctor's Visit | |
| Office Visit | $200 |
| Home / Hospital Visit | $250 |
| Maximum number of visits per day | 1 visit per day |
| Specialists Consultation Expense | |
| Office Visit | |
| Home / Hospital Visit | $250 |
| Maximum number of visits per day | 1 visit per day |
| Physiotherapy Benefit | |
| Maximum per visit | $150 |
| Maximum number of visits per | |
| calendar year | 20 visits |
| Psychologist Benefit | |
| Maximum per visit | $200 |
| Maximum number of visits per | |
| calendar year | 20 visits |
| Private Duty Nursing | |
| Maximum Per 8-hour shift Private | |
| Residence (Day) | |
| Maximum Per 8-hour shift Private | |
| Residence (Night) | $250 |
| Maximum Per 8-hour shift - Hospital | |
| (Night) | |
| Maximum no. of days per Disability | 30 days |
| 70% up to $50,000 per policy | |
| Prescribed Drugs | year |
| Prescribed Drugs | 70% up to $50,000 per policy |
| Diagnostic Benefit | year |
| Airfare Benefit | |
| Maximum Benefit | $5,000 |
| Number of trips per calendar year | 2 |
| Emergency Air Ambulance Benefit | |
| Maximum Benefit | US $18,000 |
| Number of trips per calendar year | 2 |
| Preventative Care Expense | |
| Annual Maximum | $1,000 - Blanket Cover |
| Local Ground Ambulance | |
| Benefit Maximum | 100% |
| Acupuncture Benefit (Shall only be covered when performed by a licensed physician) | |
| Maximum per visit | $200 |
| Maximum number of visits per | |
| calendar year | 20 visits |
| Chiropractic Benefit (Must be performed by a member of the Chiropractic Association and referred by a licensed physician) | |
| Maximum per visit | $200 |
| Maximum number of visits per | |
| calendar year | 20 visits |
| Radiotherapy/Chemotherapy/Dialysis | Subject to Deductible and Co- Insurance up to a maximum of |
| $100,000 Max. per Cal. Yr. | |
| Internal Plan Limits | |
| 50% of Major Med. Max. | |
| Organ Transplant | subject to R&C charges |
| 70% subject to R&C to a | |
| Durable Medical Equipment | maximum of $20,000 |
| Repatriation of Mortal Remains | $20,000 |
| Mental and Nervous Disorders | $25,000 |
| AIDS | $50,000 |
| Covid 19 & Hospitalization | $150,000 |
| Vision Care Benefit | |
| Maximum per Calendar Year | $1,250 |
| Calendar Year Deductible | $150 |
| Co-Insurance | 70%-30% |
| Contact Lenses (Incl. in Vision Max) | Paid under Vision Max. |
| Dental Expense Benefit | |
| Maximum per Calendar Year | $1,500 |
| Calendar Year Deductible | $150 |
| Co-Insurance | 70%-30% |
| Orthodontic Treatment | Not Covered |
The plan is designed to give valuable financial assistance in meeting medical costs as a result of a covered accident or sickness. It is very important that you know the scope of the benefits, since you are responsible for any amount charged for medical care in excess of the benefits payable.
Here are some frequently asked questions about the plan. We have
also placed links below to brochures for more information. Feel free to
contact the credit union office for more information.
- Who are the Providers in the Network?
Please also see map below;
Have a question?
Please check out our Frequently Asked Questions Page by clicking on the link below;
We appreciate your interest in joining the TEXTEL Credit Union Health Plan - Genmed.
To streamline your enrollment process, we have attached the necessary forms below..
For New Members Age 45 and Under: Please ensure the completion and submission of the Enrollment Form and Group Health Statement Forms.
For New Members Age 46 and Over: Kindly complete and submit the Enrollment Form, and Group Health Statement, with Part 2 being completed by a Medical Professional. (refer to the attached document).
For Dependent Addition of Existing Members (Under Age 45): For dependents under the age of 45, the completion of the Part 1 Form is required.
Additional Requirement for Dependents with Different Surnames from the Insured: For dependents with surnames different from the insured, kindly include copies of their Birth Certificate and Marriage Certificate.
The timeline for processing is determined by the insurer and can vary. The process typically ranges from as little as 3 weeks to as much as 3 months, depending on the underwriting. Once your form is complete, it will be submitted to the insurer for review and underwriting. You will be notified once coverage is approved.
If you have any questions or need assistance with the registration process, please do not hesitate to contact us @ insurance@textelcu.com.
Thank you for choosing TEXTEL Credit Union Health Plan Genmed! 🏥🩺
