Decent health insurance costs?

pmey27

Member
Oct 12, 2006
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what does it cost per month for decent health insurance? Also, is there a maximum age that health insurance can be purchased? I seem to remember a discussion where someone told me that after the age of 70 health insurance cannot be purchased???/
 

Castle

Silver
Sep 1, 2012
2,982
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It can be purchased. Only it's going to be more expensive and it's going to cover less. You cannot buy premium coverage, just basic. I have my mother (70) in PALIC, and I pay about 2,000 DOP a month. It covers emergencies, doctor's office visits (most of it, anyways), and light dental care.
 

mbgmike

New member
Jan 17, 2012
475
4
0
yes it is. its a good one but its for a family of four. no dental but vision included..most all family insurance will run a minimum of 1000 usd per month if quality insurance. ALL insurance is expensive. I don't like it.
 
Feb 7, 2007
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If you have Dominican wife (if you do not have cedula) and/or if you have cedula, for God's sake, just incorporate, and get yourself (and your family) into the social system via TSS. Even with minimum wage. You will get seguro basico (which is good, comparable to 2-nd or 3-rd level of most insurance plans, but more importantly has NO exclusions on pre-existing conditions or pregnancy), and paying small 200 - 300 pesos additional per family member (seguro suplementario), you can get a decent plan comparable to most first-level plans of the best DR insurance companies.

Calculate, a family of 4, you put your wife as the principal for the insurance, after incorporating and signing up with TSS:
8.000 pesos minimum wage, 20% all into TSS (includes not only health insurance but also contribution to pension plan, so you kill two flies with one shot)
so that's 1.600 pesos TSS contribution *. plus 300 pesos x 4 seguro suplementario (e.g. Constitucion, Simag). Total RD$2.800 pesos (US$70) per month, for a family of 4, having a SUPERIOR insurance than 95% of private insurance plans. Includes dental and vision, PLUS no exclusions on pre-existing conditions.

* TSS contribution is base don per-contributor basis but includes insurance for all dependent family, e.g. kids and spouses, in case they do not contribute to TSS themselves via their job(s).
 
Apr 13, 2011
680
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Humano Platinum with Dental for a family of four has been around 50,000 pesos every quarter - so around $1300 USD for 3 months - which breaks down to around $434 USD/month for family of four - or approximately $108.50 USD per person per month.
 
Feb 7, 2007
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Also all you, retired residents with temporary or permanent residency, INCORPORATE, even a basic EIRL will suffice, put yourself "employed" with the minimum wage, and pay into TSS, your total cost will be 20% of your wage (12% for employer and 8% for employee, obviously if you do-it-for-yourself you pay both sides) plus a small supplemental insurance to even-up to most platinum and gold private insurance plans, and you've got practically no exclusions and no age limitations as long as you contribute to TSS, Gee, come on, you can get great insurance at very affordable cost.
 

mbgmike

New member
Jan 17, 2012
475
4
0
If you have Dominican wife (if you do not have cedula) and/or if you have cedula, for God's sake, just incorporate, and get yourself (and your family) into the social system via TSS. Even with minimum wage. You will get seguro basico (which is good, comparable to 2-nd or 3-rd level of most insurance plans, but more importantly has NO exclusions on pre-existing conditions or pregnancy), and paying small 200 - 300 pesos additional per family member (seguro suplementario), you can get a decent plan comparable to most first-level plans of the best DR insurance companies.

Calculate, a family of 4, you put your wife as the principal for the insurance, after incorporating and signing up with TSS:
8.000 pesos minimum wage, 20% all into TSS (includes not only health insurance but also contribution to pension plan, so you kill two flies with one shot)
so that's 1.600 pesos TSS contribution *. plus 300 pesos x 4 seguro suplementario (e.g. Constitucion, Simag). Total RD$2.800 pesos (US$70) per month, for a family of 4, having a SUPERIOR insurance than 95% of private insurance plans. Includes dental and vision, PLUS no exclusions on pre-existing conditions.

* TSS contribution is base don per-contributor basis but includes insurance for all dependent family, e.g. kids and spouses, in case they do not contribute to TSS themselves via their job(s).

My family is dominican so i will look into this. Mine eats us up. thank you
 
Feb 7, 2007
8,005
625
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For those who do not know how TSS works, you still can elect your preferred insurance company (Humano, Palic, Constitucion, whichever) and you contribute to TSS pool, TSS then gives its share of money to each insurance company based on the number of insured people. This is called Plan Basico de Salud. Some smaller insurance company offer no-fee increased coverage (e.g. you can wider coverage that PBS) at no cost. Most insurance companies offer supplemental insurance plans which you pay directly to them (not to TSS) and that way you can even-up to best private insurance plans. For example, ARS Constitucion has a 100-pesos-per-person supplement which evens up your PBS to their Tier-2 plan, and 200-per-person-per-month supplement evens up your PBS to their Tier-1 plan (very very good), and there are some more expensive supplements that offer you excess coverage that even NO PRIVATE insurance plans offers.

Advantages of PBS (and supplements) is NO EXCLUSIONS on pre-existing conditions, catastrophic illness, pregnancy, and NO WAITING periods. With a private insurance plan, you have to wait a month to visit emergency and lab tests, 2 months for a doctor's visit, 3 months for some more advanced testing, 6 months for outpatient surgery and even 12 months for non-emergency (they call it elective*) surgery. With PBS you have NO WAITING period, for anything. You're in today, and tomorrow you can go have an open-heart surgery.

* I don't know why they call it elective surgery, like anybody really "elects" to have open heart (or similar) surgery ... like ooh I feel like going for a 12-hour surgery this week, why don't you cut my chest in two so I can have a nice week-long hospital vacation...?
 

Drro

Bronze
Mar 22, 2006
1,407
102
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How complicated is it to incorporate. I will have a cedula in a couple of months together with temporary residency and am very interested in obtaining insurance here. I am over 65 so it hasn't been easy to find.
 

Castle

Silver
Sep 1, 2012
2,982
1
0
How complicated is it to incorporate. I will have a cedula in a couple of months together with temporary residency and am very interested in obtaining insurance here. I am over 65 so it hasn't been easy to find.

It's not complicated at all. Just go the insurance company of preference and tell them you want to get into the system. Tell them you are self-employed, and they will tell you how much you need to pay every month to be part of the system. Since this kind of insurance covers all pre-existent conditions, you don't have to go through medical exams.
 
Apr 13, 2011
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Rubio or Castle - could you let us know the steps to incorporate as self employed (or have spouse with cedula be principal) at a minimum salary - and then how exactly do you set up the TSS and selection of Insurance??
Are there any potential drawbacks to doing this?? Because this seems to be a very good option - just wondering if it is too good to be true :) If it relatively easy, I am interested.
 

Castle

Silver
Sep 1, 2012
2,982
1
0
Rubio probably has more current info, but as far as I know this insurance covers your spouse and children. If you are in DR, I would suggest visiting any insurance company (ARS in this case) and get accurate details from them, or going online and browsing their websites. They all offer this kind of insurance, by law they have to. The biggest ARS are

- ARS Humano
- PALIC
- ARS Universal
- Seguros Banreservas.

Too good to be true?. Well, there are limitations, of course. I guess coverage is not as high, they don't cover injuries for car accidents (that's supposed to be covered by car insurance), an they almost never cover 100% of doctor's fees, more like 75-80% depending on the cost of the doctor or procedure.
I can tell you I've used it many times, emergency rooms are covered 100%, i've had surgeries, all kind of procedures, no problems whatsoever.My wife was also covered (not that she stopped being covered, she just stopped being my wife)

I think this kind of insurance is called Seguro Basico de Salud and if I'm not mistaken, I think you don't have to be employed to get the insurance. It's the other way around: if you are employed you must have it, whether you use/need it or not.
 
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pmey27

Member
Oct 12, 2006
339
0
16
It can be purchased. Only it's going to be more expensive and it's going to cover less. You cannot buy premium coverage, just basic. I have my mother (70) in PALIC, and I pay about 2,000 DOP a month. It covers emergencies, doctor's office visits (most of it, anyways), and light dental care.

so if one is 70+ then for 2000 pesos/month basic coverage is ok...what if hospitalized over night or say for a longer period of time? thanks!!
 

Criss Colon

Platinum
Jan 2, 2002
21,843
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yahoomail.com
I have Servicio Dominicano de Salud, "SDS"
Have had it for over 15 years. My family is 3 adults, three kids. Costs 15,000 pesos every 3 months.
Have used it Many, many times!
It always pays everything, except for the private room.
mgMike, you must have some international ins. provider. The amount you are paying is ASTRONOMICAL!!!!I can not comprehend that amount!
To me it seems unnecessary.
Shop Around!
Or are you talking about health Ins. in the USA???
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mbgmike

New member
Jan 17, 2012
475
4
0
I have Servicio Dominicano de Salud, "SDS"
Have had it for over 15 years. My family is 3 adults, three kids. Costs 15,000 pesos every 3 months.
Have used it Many, many times!
It always pays everything, except for the private room.
mgMike, you must have some international ins. provider. The amount you are paying is ASTRONOMICAL!!!!I can not comprehend that amount!
To me it seems unnecessary.
Shop Around!
Or are you talking about health Ins. in the USA???
CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC

i have blue cross blue shield. yes its from the usa