Government Cuts Work Permit Holders from Treatment Abroad Programme Amid Rising Costs

The Turks and Caicos Islands Government has announced sweeping changes to its Treatment Abroad Programme (TAP), removing work permit holders from eligibility and tightening residency requirements, citing spiralling costs that officials say are no longer sustainable.

Premier Charles Washington Misick

Premier Washington Misick made the announcement during his State of the State Address on Thursday, February 26, at The Shore Club, drawing applause from attendees as he outlined reforms aimed at protecting the public purse.

“The Treatment Abroad Program alone has increased from $40 million in 2024 to $61 million in 2025,” Misick said. “That is more than 10 percent of our entire budget. That is totally unsustainable.”

Immediate Restrictions

Effective immediately, and subject to legislative amendments, access to the government-funded programme will be restricted to Turks and Caicos Islanders and British Overseas Territory citizens who are resident in the country.

“It is absolutely necessary,  it’s imperative,  for us to restrict access to the Treatment Abroad Program,” the Premier declared. “We can no longer afford to pay for people on work permit.”

Under the new policy, employers and individuals on work permits will be required to secure their own major medical insurance coverage for overseas treatment.

“That means that large employers and people on work permit will have to find a way to procure major medical insurance for treatment abroad,” Misick said, adding that the shift presents “a business opportunity for somebody in this room.”

Addressing Abuse of the System

The Premier also acknowledged concerns about abuse of the programme by residents who permanently live overseas but continue to benefit from the system.

“We understand it’s being abused in other ways, by us — who are putting families who live abroad on the program. And when they get sick, we fly them to the Cayman or Colombia or somewhere else. That is going to stop too,” he said.

Going forward, residency in the Turks and Caicos Islands will be a firm requirement for TAP eligibility.

“One has to be resident in this country to benefit from treatment abroad. We have to be smart, otherwise we’ll be taken advantage of,” Misick added.

Expanding Local Healthcare Capacity

While announcing the cost-cutting measures, the Premier emphasized that the government remains committed to strengthening the national healthcare system through the National Health Insurance System (NHIS).

“My government continues to protect access to health care through the National Health Insurance System, so that families are not pushed into financial hardship because of illness,” he said.

As part of efforts to reduce reliance on overseas care, the premier said government is moving forward with plans to establish the country’s first polyclinic. He said the administration is in the process of finalizing the acquisition of Family Care Medical Center, in Providenciales, to create a one-stop community health centre where residents can see a doctor, access basic diagnostic tests, receive treatment and obtain preventive care services without having to visit the hospital.

“And God knows there’s too much traffic at the hospital,” Misick remarked.

He also revealed that Minister of Health Hon. Kyle Knowles is working on plans for a second polyclinic in Blue Hills, Providenciales.

Focus on Prevention

In the meantime Premier Misick urged residents to take greater responsibility for their health, noting that preventive care can significantly reduce long-term healthcare costs.

“A simple annual checkup costs, depending on where you go, less than $50,” he said. “Use your clinics. Get screened early. Take care of your health now, because prevention today protects your future tomorrow.”