Getting DR or Intl Health Insurance if Already Pregnant

linzer

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Oct 5, 2012
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What are the opinions out there about being able to get local DR health insurance or International health insurance (Universal) if I'm already pregnant? (3 months) The application for International coverage asks if I'm pregnant, or suspect I might be. What if I don't say anything about being pregnant? I'm not sure how the local coverage works, if there's an application or not. Thoughts? I want to have the baby here in the DR. Thanks
 

Mauricio

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Nov 18, 2002
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They won't cover it, even if you get pregnant three months AFTER signing up. I had to pay for our last child's birth myself while we changed insurance when my wife was pregnant.
 
Feb 7, 2007
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Do you have Dominican cedula? if so try to get coverage via TSS. Do you have spouse/common law partner who is legally working in the DR? You can get coverage via TSS through them. If you get coverage via TSS, insurance company will cover any preexisting condition including ongoing pregnancy.
 

dv8

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Sep 27, 2006
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i called universal for ya. your pregnancy will not be covered if you sign in pregnant, whether you tell them or not. the insurance will only cover the pregnancy and birth if you get pregnant minimum 31 days after signing up. the only exception to that is plan basico de salud. but you can only be affiliated to that plan by an employer.

so, as rubio says: if your partner is employed you can join him in the basic plan. or if you will find someone to employ you and sign you up for the company plan. other than that no luck. i suggest you have a baby wherever you come from or prepare to pay about a 1000 dollars for birth in DR. unless you opt for a public clinic, then it is free.
 

Mauricio

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Nov 18, 2002
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i called universal for ya. your pregnancy will not be covered if you sign in pregnant, whether you tell them or not. the insurance will only cover the pregnancy and birth if you get pregnant minimum 31 days after signing up. the only exception to that is plan basico de salud. but you can only be affiliated to that plan by an employer.

so, as rubio says: if your partner is employed you can join him in the basic plan. or if you will find someone to employ you and sign you up for the company plan. other than that no luck. i suggest you have a baby wherever you come from or prepare to pay about a 1000 dollars for birth in DR. unless you opt for a public clinic, then it is free.

Try 5000 dollars
 

dv8

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Sep 27, 2006
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the c-section i have seen in POP were all below 1000 dollars, including a hospital stay. if you paid 5k it was either a ripoff of the year or the child/mother suffered complications... then, of course, you may have to fork out a lot more than this...
 

linzer

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Oct 5, 2012
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$1000 sounds amazingly cheap!! $5000 would be ok. If I went back to the US I bet I'd pay closer to $20K to have a baby without insurance. (Or perhaps even with the crappy insurance plan I have there.) Neither my husband nor I are working here, so the employer option isn't feasible, unless I magically find a job. I guess it could happen.
Thanks for your input. And thanks very much dv8 for calling Universal. That was awesome of you.

Any suggestions on places (not a public hospital) for a doctor or mid-wife (preferably nurse mid-wife) birthing center near Sosua/POP ?
 

dv8

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Sep 27, 2006
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my sister in law is pregnant now and her doctor is in clinica gregorio hernandez (POP). i will ask her for the name of the doctor. she'd go to the best there is :)

normally c-sections are routinely performed in DR over natural births so prepare yourself for that. a final charge will depend on a hospital, room and other services. a year and a half ago i had a hysterectomy procedure in clinica union in santiago, one of the best in the country. i stayed in a super exclusive room and my doctor is rather pricey. the total was 54k pesos, less than 1500 dollars. c-section would not be much different.

no problem calling universal. it is a major pain in the neck just to get passed the automatic dial system...
 

Mauricio

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Nov 18, 2002
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I should add we decided to go for 'elite' doctors and a good hospital. Not because we are elite or think we are, but because I prefer to be safe than sorry.

85000 gynecologist
40000 pediatrician
28000 anesthesiologist
60000 clinic

No complications, only a night monitoring the baby for being on the heavy side (I had never heard of that nonsense, something with glucose levels).

One issue that should make you consider giving birth in your home country is that most of the time the insurance does not cover any problems the child might have when he or she gets born, if the pregnancy wasn't insured.
 

dv8

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Sep 27, 2006
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yes, mauricio, anything special costs a lot of money, especially in SD. i know that some doctors can charge 100 dollars per visit...

my quote, on the other hand, was for a standard c-section in a private hospital in POP, no complications, just cut, a day or two in a clinic and basic care. it is good to know about exclusive option too, in case someone wants the best of the best.
 

devdev

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May 14, 2011
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linzer~ I was in the exact same situation as u! found out I was pregnant at 2 months. My husband works so he has insurance with humano- they stated I needed a cedula to be a part of his insurance. So as we hadn't been married 6 months yet (to apply for my cedula I needed to be married 6 months first), we asked to purchase the insurance. So I got the royal plan and paid about 1900 pesos....which we had to add maternity on. Not only AFTER we added maternity did we found out it DOES NOT cover the birth....what the hell ...so anyhow it covered ultra sounds,cheaper doc appts... and stuff like that...but ultra sounds r cheap anyways so we pretty much paid all that money a month to have a cheaper ultrasound....unfortunately for us, we (as I was pregnant and hadn't got a job yet) didn't have a lot of money for the birth. The nice, clean hospital I was at first was going to charge 30000 pesos for birth , 45000 for C-section. But as we didn't have a lot of money, I ended up going to the women's hospital in santo domingo where it only cost me 14000 pesos for a C-section....but let me tell u...omg that hospital coulda have been in a horror movie!!! Never in my life had I seen such disgusting things...especially the lack of cleanliness!! They didn't even have a sheet of toilet paper in the hospital ...NO WHERE!!!- b.y.o.t.p. lmfao r u serious!!!??? u have to lie on sheets (not the usually hygienic paper the doc usually tears off when u leave and pull it down fresh for the next person)....as I was having an exam on my vijayjay-a man just walks in...why-cause thr is nooooooooo door or sheet covering it for exams!!!!!!!! the ultra sound room was honestly the size of a bathroom and the walls were black with mold!!!! the wheel chairs they pushed u around I don't think have everrrrrrrr been cleaned!! the room I stayed in didn't even have a shower head to shower, just poured out the broken spout....when given 2meals a day, ur lucky if one came with a beverage lol...as they have students learning thr, the one day they just ripped open the curtain and wanted to look at my vijayjay with 20 ppl standing thr~umm I think not!! and they didn't even ask first...I had complications with bleeding so the first time I was admitted, I went to the bathroom...ya blood everywhrrrrr!!! all over the garbage cans,, toilet....so I had to stand and pee...then of course no t.p. (thanks god I carry some with me)...go to wash my hands...ya no soap....o and no water!! wtf kind of womens hospital do these ppl run!!!! sorry for my rant lol needless to say-never go to a public/semi-public hospital it is a whole nuther world!!!!
 

Criss Colon

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Jan 2, 2002
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yahoomail.com
"Cedula", never heard of that requirement!
I am an "Ilegale" here in the DR.
I have ARS Humano.
They have paid thousands, and thousands, of pesos for health care for me and my entire family.
CCCCCCCCCCCCCCCCCCCCCCCCCC
 

dv8

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Sep 27, 2006
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i think she is talking about PDSS or whatever it is called, the basic insurance that you get either from work or as a part of a package with work insurance of the partner. i believe they do want the cedula then. private plans can be taken with passport only...
 

devdev

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May 14, 2011
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sorry guys maybe I wasn't clear...I mean to get on my husband insurance with humano they said I require a cedula...I do have humano insurance now but I pay 1700 pesos a month...being on my husbands I wouldn't pay anything :)
 
Feb 7, 2007
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That's correct, you need cedula (and residency) in order to be on plan basico de salud (statutory health insurance for working people), either directly or as a spouse of a person that has PDSS.

As I expressed previosuly, PDSS (plan de servicios de salud aka plan basico de salud) along with complementary health plan (quit cheap monthly premium on top of PDSS) you get BEST health insurance in the DR, better than any private (voluntary) health plan, because you get covered for preexisting conditions, pregnancy, catastrophic illness, medications, and the coverage is IMMEDIATE with no waiting periods, no exclusions, no nada.

And what's more, the insurance company covering your policy under PDSS is the same insurance company that covers private/voluntary health plans. You can SELECT your insurance company under PDSS. While they all offer same PDSS coverage, they differ in price/quality/coverage of complementary plans you can get on top of PDSS. And the trick to best health insurance in the DR is combining the PDSS with complementary plan offered. You still get better bang for your buck, and much much better coverage than you would on any private insurance plan.
 

dv8

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Sep 27, 2006
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true enough. i have an arrangement like that: when i first arrived to DR i was hooked up to miesposo's plan (offered by his employer). i also have complimentary insurance that he wants to upgrade now. that was one of my requirements upon moving to DR. i just wanted to feel safe in case i get ill.
 

Hillbilly

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Jan 1, 2002
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A little horror story, not involving pregnancy:

Let's call him Lee, not his first name.
He comes down here and the first thing he asked me about was whether the pharmacies here sold Oxa-forte. I said sure they do.
So, okay, he gets here and gets set up with his high speed internet and starts working and as I sort of realized, the delivery guys from the local pharmacies were regular visitors.
And sure enough, two months later he comes out of his place, and collapses in the patio. Big mess, but I get him to a clinic and he is a mess.
Long and short of it was that he was addicted to non-prescription pain meds which also happened to be very bad for his stomach and caused a large (I saw the video) ulcer which ate into a vein and caused him to bleed out! Gory, yes, but true.
Pints and pints of blood used until the docs went in and sewed up the leaking vein.

Two weeks in ICU = life saved but at a cost of US$39,000....

He is now on the hook for quite a while, but he is alive. Shame of it is that he had no insurance and if it was not for some associates who went to bat for him, he would now, most likely, not be among the living, since the local regional hospital would not have been capable of saving his life, since they don't even have band-aids!

I learned a lesson: nobody here without some health insurance.

And never sign anything! You might be held responsible for someone else's stupidity.


HB