medication plans

rogerramjet1 said:

My girlfriend has now been diagnosed with a condition requiring monthly ongoing medication

. Are there any health plans that i can buy so that the insurance company will pick up the tab for all the medication? What sort of money per month?

shes 25, good health, dominican

But it must cover the entire price of medication

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Most plans that I've seen have pretty limited coverage for medications - 5,000 - 10,000 pesos/yr. Any plan that might cover most of the cost of medications would be very expensive - if available at all(?).

Make sure you look for the generic version of any medication proscribed. Most docs will give you a prescription for the brand name - or a combo that is cheaper to buy separately as a generic. They don't know what these meds cost - and it's your money they're spending, not theirs.

Yes, there are plans that cover, but as mentioned above they have their limits. I'm Humano Max for many years now, and I am now covered for up to 15,000 pesos worth of meds in a 12 month period. My plan started with coverage of 5,000 pesos per 12 month cycle. Take this into consideration: If you have an event, surgery/serious injury etc., you may use up that limit very quickly, and trust me, they will red flag you when the time is up. From my experience, little meds here and there, it is best to go out of pocket. One shot deal and done, when needed. Not that big of a deal. I'd rather have the Big Boys on standby when/if ever needed. Case in point: Two years ago a friend of mine broke his leg in a moto accident. He was fortunate to have a good job, hence, decent benefits that picked up his surgery and hospitalization in a good clinica here in SPM. He exhausted his annual med benefit in 6 days. Yes, 6 days.
Side note #1: If the woman is pregnant, companies want her to be insured for at least 9 months before they will cover her delivery/C-section procedures. This is to ensure that people don't jump on a plan once the novia/esposa is pregnant. The companies are privy to this game.
Side note #2: Do not send your girlfriend money to purchase this plan. Read this prior sentence. Comprehend that sentence. Read the first sentence again. Go WITH her in person. Purchase the plan for her on YOUR terms, if YOU'RE the person paying for it. Meaning how you wish to pay. Quarterly. Bi-Annually. Or the year full and complete. These options ARE available to you. Also make sure she is the ONLY person on this plan. Save yourself headaches in the future with a little heads up advice now.

rogerramjet1 said:

Thank you all.
She has sent me a photo of name brand medication 15000rd a month

. I wonder what the generic would cost?

Thanks anyways

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My god thats expensive. Make sure you arent being hustled. You can also google the med yourself and see if there is a generic available. Good luck

sanpedrogringo said:

Yes, there are plans that cover, but as mentioned above they have their limits. I'm Humano Max for many years now, and I am now covered for up to 15,000 pesos worth of meds in a 12 month period. My plan started with coverage of 5,000 pesos per 12 month cycle. Take this into consideration: If you have an event, surgery/serious injury etc., you may use up that limit very quickly, and trust me, they will red flag you when the time is up. From my experience, little meds here and there, it is best to go out of pocket. One shot deal and done, when needed. Not that big of a deal. I'd rather have the Big Boys on standby when/if ever needed. Case in point: Two years ago a friend of mine broke his leg in a moto accident. He was fortunate to have a good job, hence, decent benefits that picked up his surgery and hospitalization in a good clinica here in SPM. He exhausted his annual med benefit in 6 days. Yes, 6 days.
Side note #1: If the woman is pregnant, companies want her to be insured for at least 9 months before they will cover her delivery/C-section procedures. This is to ensure that people don't jump on a plan once the novia/esposa is pregnant. The companies are privy to this game.
Side note #2: Do not send your girlfriend money to purchase this plan. Read this prior sentence. Comprehend that sentence. Read the first sentence again. Go WITH her in person. Purchase the plan for her on YOUR terms, if YOU'RE the person paying for it. Meaning how you wish to pay. Quarterly. Bi-Annually. Or the year full and complete. These options ARE available to you. Also make sure she is the ONLY person on this plan. Save yourself headaches in the future with a little heads up advice now.

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My case exactly. My wife was just in a moto accident. First week - 3000 pesos in meds and that's only because I know what the generics are.

Went back to the doc today - another 3000 for one week and that's only because I know how to ask for the generics. If you don't, and/or don't speak Spanish well, double or triple that. And this is just the beginning!

The farmacias want to sell you the most expensive brand they have. I'll bet what you pay for the extra med coverage is about the same as the extra cost I pay for the meds!

rogerramjet1 said:

Thank you all.
She has sent me a photo of name brand medication 15000rd a month

. I wonder what the generic would cost?

Thanks anyways

Click to expand...

Another thing to consider is that, as far as I know, insurance companies here do not cover existing conditions, so chances of getting an insurance policy now to cover this are slim to none. They don't have Obamacare type insurance down here.

Wow. Much to hit on here.
1. OP, I hope your GF does well. That amount sounds incredibly insane for a monthly med cost here in the DR, but only you know of the situation, and that is your business. Read the advice provided, and be careful.
2. Cavok, sorry to hear of the unfortunate incident. If you need any assistance, or an open ear, private message me. I don't pay extra money for the extra med coverage. It has gone up incrementally each year that I have maintained the plan. That was their agreement with me when I signed onto the plan. Things may have changed since I signed on in 2007, but I only speak of what I know. Also, I never once had to take a medical in regards to my plan, and Humano is one of the better coverages here in the DR. Final note, and a point of contention for some here on this forum, I do not, nor never have, had residency here in the DR, and yes, I have full medical insurance. Why? Because I pay for it. Residency is not needed. You go to an office with your passport, and purchase a plan. I actually recommend this for those that are either snowbirds (3-4 months) or those that visit 3-4 times per year. You will not be denied, and it is better to have the coverage and not need it, than need it, and not have it. Kind of like a condom. They call it protection for a reason. Jokes aside, no, I am not looking to open up another debate about 30 day tourist cards, overstayers, and what have you, but the truth is, anybody can buy a healthcare plan here and be covered. You do not want to spend time in a public hospital here in DR, not even for stitches. Without debating the entire world on the topic of "get your residency now" private message me if you have questions regarding obtaining coverage......and no, I am not selling it either.
**I was about to hit Post Quick Reply when I thought of something else: My health coverage here also includes and covers dental work, and eye exams. Something that is a little different from health plans back in the States. In the States, I have 4 different plans for these items.....Health, Meds, Dental, Eyes. Here, it's all in one. Just the facts.

@ The OP:
I posted this on your other thread:
Do the homework on these meds. This woman does not NEED this medication. She's a doctor as well? Sounds like she's taking you for a ride. A ride for her new Yipeta, which you won't be riding in. Sad, but true. If I am wrong, private message me.
Let me guess, she needs the money by tomorrow 9am?

rogerramjet1 said:

Thank you all.
She has sent me a photo of name brand medication 15000rd a month

. I wonder what the generic would cost?

Thanks anyways

Click to expand...

My friend. Your girlfriend is still in the DR? Where are you? Reading between the lines it sounds you have travelled home or to another country and she is left to fend for herself. Something doesn't add up here. When you say she has sent a photo of what the medication is, does that mean that she has e-mailed you this. I am a little confused and don't want to come to any conclusion as to what is transpireing here but it feels like you are leaving out important details about this situation. Obviously, you don't owe me or anyone an explanation but since you have made this public I am trying to determine what the RD15,000 pesos is really for. That is $300+US dollars per month for drugs in the DR. That sounds very expensive. Just trying to understand your situation?????????????????????????????

15,000 pesos a month on a single medicine is a lot. i have only seen these kinds of price tags on meds for cancer, severe brain trauma, AIDS and generally catastrophic instances.

as others said, there is no plan that covers the entire cost of medication, all the time. maybe it she was in a hospital for treatment like chemo... and even then insurances have a limit for the total of money spent.

The med explanation is on his other thread.

also, just to clarify: insurance companies do not cover every single medicine, even with good plans. personally i only use my pharmacy plan on rare occasions when i have more serious illness such as bronchitis and need longer treatment. that alone could drain yearly allowance. the main point of health insurance is coverage in case of accidents, hospital stays and other emergencies and disasters.