Hello. I have visited Cayo Levantado and Samana and can fill you in.
There are some pros and some cons:
First the cons -
As far as I know, no one lives on Cayo. It exists as a nice white sand beach with amenities for visiting foreigners, in my opinion. (There was a hotel under construction last I knew.)
While there, I had one too many beach vendors ask me to buy stuff. If you'd rather not buy, do not waste your time and theirs explaining why not, simply say NO GRACIAS and avert your eyes. Done.
There are many open-air restaurants. It seemes that they had reservations from All Inclusive hotels, because boats would land and large groups would head to the restaurants. You can find space for just a few folks. Walk around and ask about the different menus.
My friends and I were only 4 and did have a nice meal which was decently priced for Europe/Canada/USA, but ridiculously high for a Dominican.
I saw no Dominicans there relaxing. They were all working. This is not a typical place where you can see any Dominicans.
In the 2004 hurricane, a lot of the topsoil was blown away and folks discovered that under it was tons and tons of styrofoam and trash - the food vendors had been burying their trash on the beach! But they were clean when I was there, and we did not get sick from the food.
NOW, let's see the good news - it has nice sand and nice palms and is fairly picutesque and you're surrounded by the security of other vacationers, I guess.
Myself, I much prefer Playa Rincon, but you have to plan ahead and/or speak some Spanish to pull that off.
You CAN get into Samana - contact Kim at Victoria Marine in Samana - she probably can get you into town and back in time for your boat. (She is the #1 whale watching guru and long-term resident.)
If you don't go with her, take a BIG boat - the small ones can be choppy and very unsafe - safety regulations are nill here. Make no assumptions.
I am looking for more good news on Cayo.........Guess I am rather jaded against it.
Um, you can use dollars. Most all vendors speak English. As far as I know, the shopping is limited to tourist type of trinkets, very few higueros (carved gourds). The paintings were all the same colors and style you see in that area all over. Nothing original.
One good thing to buy -
jewelery.
If Mr. Green is there, ask for him. Speaks English and German, and is a church-going local.
He can sell you necklaces and braclets that are different - they have a blue beetle shell in the middle with horizontal stripes, and the chain is made of a brown shell like turtle shell, but different.
Pay between $20 and $30 - quality varies.
And trust any answers that Mr. Green gives you. He is also a great taxi driver and guide in that area.
If you get to Samana, eat lunch at the french cafe on the side street, off of the Malecon. Expensive - but good. Bambu is also okay.
Ask a goldcart sized motoconcho to take you to a village LOS CACAOS and back. Pay him 100Pesos when you are done.
Motoconchos in town go for 10 pesos.
Get a shoe shine for 10-20 pesos, and tip heavy. Those 6-12 year old boys are supporting their mothers and brothers.
OH - If you acn get off of CL at 8:00, early-ish. Go to the main street and hail a motoconcho for the market. It is wild - like an african market. Buy a bachata CD in the music store.
I forgot THE MOST IMPORTANT THING ON CAYO --
BRING YOUR OWN TOILET PAPER. In fact, just plan to travel with a pocket package of kleenex that can do double duty as needed.
ENJOY!