The present paper seeks to contribute to the growing discussion on social protection through an assessment of the status of social health protection systems for the elderly within the English-speaking Caribbean, and a review of the systems in Jamaica and Trinidad and Tobago. It was prepared as a background document for the Expert Group Meeting on Social Health Protection for Vulnerable Populations which was held in Port of Spain on 31 October 2011. Against the backdrop of demographic changes underway in the Caribbean, the paper analyses the schemes and mechanisms that have been instituted by Member States towards ensuring decent living standards for the elderly by ensuring adequate provision of health care and long-term care. The paper highlights the emerging challenges and discusses the need for reforms and policy interventions, in the context of the long-term impacts on the health and social security systems of a rapidly-ageing population and the parallel increase in the prevalence of non-communicable and chronic diseases.