Any Recommendations on Domestic Medical Insurance?

Lucas61

Lucas61

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Jun 13, 2014
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retired English teacher (30 years)


A physician friend in S.D. recommended that I purchase domestic insurance in the event that I need to use a non-public hospital, such as Plaza de la Salud, where there are some English speaking staff and modern equipment, since I couldn't otherwise afford to pay.

Public hospitals, like Padre Billini, can be fine unless you are in serious trouble and fumbling for a Spanish verb. Being sick and in pain is not the time to be learning Spanish. When it comes to being precise, particularly in terms of giving a medical history of many years and different pathologies, there is no substitute for one's primary language.

Anyway, without giving me any details, these are the policies he recommended I choose from:

Mapfre (office on Lincoln near Agora Mall)
Palic
Scotia Bank (?)
Universal

Does anybody have personal experience with the above (or a different policy)? Hint: I'm looking for a recommendation based on personal experience. Of course, I also need to check with Plaza de la Salud to find out which policies they accept and which they prefer. No sense in buying a policy only to find out that your chosen hospital doesn't accept it. And when I do choose a policy, I will definitely read the TOS in English . . .
 
Lucas61

Lucas61

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OP Update:

I just checked U.S. Embassy website which confirms that Plaza de la Salud, which they recommend, accepts:

Assistcard, AXA Assistance, BUPA Medical Services, Claria Life, Delaware Life Insurance/Metlife, Emergency, Frontier Medex, Henner-GMC, Inter Mutuelle Assistance, MetLife, QHM, Redbridge, Worldwide Medical Assurance, Seven Corners, SunMed International, Vumi Group.

Of these, I am zeroing in on Worldwide Medical Assurance (WorldWideSeguros) which has a principal office on Lincoln, not far from the hospital . . .
 
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Bob K

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We have universal and with three surgeries (all pretty minor) resulting in 5 hospital days I have no complaints. All took place at HOMS in Santiago

Bob K
 
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rubio_higuey

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Lucas61 said:
Of these, I am zeroing in on Worldwide Medical Assurance (WorldWideSeguros) which has a principal office on Lincoln, not far from the hospital . . .
Click to expand...

Why would you buy a policy from a foreign carrier, for use in the DR, is beyond my understanding.

Universal
Constitucion
Humano

in that order.
I would avoid Palic I have heard they require a lot of pre-authorizations, which is also case with Humano. I put it on the list because it's the largest and best known and has an excellent payment record.
Neither Universal nor Constitucion require lots of preauthorizans or doing tests A first to authorize tests B or a full folder of doctors' opinions and second opinions, for just to authroize a 15,000 RD$ exam.

I have been with Constitucion both on private plan and now on TSS with complementary plan, and I cannot say a bad word. I have had some exams/tests (fortunately just as a matter of routine) authorized without a question for which other insurance carriers (especially Palic) made other patients do myriad of tests/exams and doctors' opinions, in order to authorize.
 
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dv8

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Sep 27, 2006
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mapfre has health insurance? the only two companies to consider is humano or universal. stick to those and you will be fine. this has been discussed here hundreds of times so just use search button for more details.
 
bob saunders

bob saunders

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dv8 said:
mapfre has health insurance? the only two companies to consider is humano or universal. stick to those and you will be fine. this has been discussed here hundreds of times so just use search button for more details.
Click to expand...

My wife and I have Palic , which is neither HUMANO or UNIVERSAL. Works just fine and is accepted by most doctors and private clinics. I have Mapfre auto insurance. Pre-authorizations are relatively pain free. My wife just had sonogram, mammogram, and operation all pre-authorized quickly and relatively cheap, especially the operation, all done at Union Medical which has insurance offices right there at the hospital/clinic.
 
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rubio_higuey

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dv8 said:
mapfre has health insurance? the only two companies to consider is humano or universal. stick to those and you will be fine. this has been discussed here hundreds of times so just use search button for more details.
Click to expand...

I would personally take Constitucion over Humano any time. Universal would be first on my list, Constitucion second. They are really a good company with plenty of coverage at most reasonable cost, and with least administrative hassle. They are what Humano used to be 15 years ago.
 
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mountainannie

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Lucas61 said:
OP Update:

I just checked U.S. Embassy website which confirms that Plaza de la Salud, which they recommend, accepts:

Assistcard, AXA Assistance, BUPA Medical Services, Claria Life, Delaware Life Insurance/Metlife, Emergency, Frontier Medex, Henner-GMC, Inter Mutuelle Assistance, MetLife, QHM, Redbridge, Worldwide Medical Assurance, Seven Corners, SunMed International, Vumi Group.

Of these, I am zeroing in on Worldwide Medical Assurance (WorldWideSeguros) which has a principal office on Lincoln, not far from the hospital . . .
Click to expand...

those are international plans.. they also accept all these local plans Aseguradoras Nacionales | CEDIMAT

how long are you planning to stay? if less than 6 months maybe travel insurance? although local insurance will probably be cheaper, but i do not know if they offer a policy for less than a year and if you just stop paying on a policy you will have trouble getting insurance again

i have Universal.. great service, great coverage,
 
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rubio_higuey

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Local policies have no "time limits" but on private plans, most services kick in after 3 or 6 months.
Usually, emergency is immediately, doctor's consultations after 1 month as well as basic tests (blood work, etc.)
Same goes for emergency surgery (appendices, etc.)
Specialized exams kick in after 3 months, and elective surgeries (basically any non-emergency surgery) kick in after 6 months.
 
Lucas61

Lucas61

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Jun 13, 2014
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retired English teacher (30 years)
OP Summary:

I made a list of your suggestions and ticked off, one by one, pros and cons. The winner is Universal as it is the only policy for which no one stated a negative. So I will begin with that.

Thank you, dr community, you are #1 -- Except when you cop an attitude! LOL!
 
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