What is the contributory plan? do you need to be officially working here or just have a cedula? can you get this along with the ARS plan and if so what benefit. I ask because I had an emergency visit 2 years ago that resulted in a week stay and the bill went a 200k dop over the per visit ARS limit which I believe was 250k
Yes you must be working and your employer pays the percentage and you pay the percentage. Total is about 10% of your salary. This will give you Plan Basico. While the coverage of plan basico (moneywise) is a bit inferior to good private plan, you get no waiting period (you can have surgery the very next day), immediate pregnancy coverage, and what is most important, pre-existing conditions. Also, you get "catastrophic illness" coverage up to 1 million pesos (private plans limit on your per-case basis), plus vaccines for children, dental plan, and pharmacy up to RD$3000 per year. You can also affiliate for NO ADDITIONAL COST your spouse and your/her children under the age of 18 or even after age of 18 when they are studying full time. You can elect your ARS, but all ARS offer the SAME coverage under plan basico.
But the trick is not to stay with Plan Basico. On top of Plan Basico, you can get complementary plan (plan complementario) with the ARS, which increases your coverage for a fixed monthly fee. NOW it's where the game begins, and where it is good to have the "correct" ARS. The coverage and monthly fee for complementary plans vary. One of the most expensive ones is Humano which has the worst price/benefit ratio for complementary plans. Universal is in the middle, but I would elect Universal for a private plan where their coverage is excellent, not for plan basico + complementary plan.
I have had private plan with ARS Constitusion, really great coverage at very reasonable cost. Now that I have residency, I officially employed myself in my company on a part-time basis. I already have Dominican national social security number and I am already enrolled in Plan Basico as of this month. As of July 1st, I will also have the complementary plan, called Clasico II, with the same ARS Constitucion. For a small monthly fee of RD$470 (per person, so if you are enrolled with spouse, while there is no additional charge for plan basico, complementary plan would be CP cost x 2), so for this small monthly fee I get 100% ambulatory and hospital coverage, which means ZERO co-payment on anything, with the exception of very highly specialized exams (like magnetic resonance, nuclear medicine etc.), and I have room coverage of over 5.000 pesos per day (most private plans have room coverage of 2000-3000 pesos per day). Plus, my catastrophic coverage is increased to 1.35 million (from the plan basico 1 million).
To get plan basico (and later complementary plan) you need to be employed in a company (your own, for example) and pay the contributions to the local social security system. You get affiliated with any ARS of your choosing prior to starting contributing to the system, and you can change your ARS after 12 months.
