Coverage and costs of health insurance in The DR?

Matem?tico

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Mar 25, 2014
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Hi all, as my family and I prepare for the adventure, I'd love to get some exact info on family health coverage
while in the DR. Two adults, one child, and mother-in-law. What's covered and not covered and related costs?

Thanks in advance.
 

drSix

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Oct 13, 2013
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This is a link to a pdf in English with all the details of the plan.

I have the Humano Max plan without maternity. It is RD$1600 per month, per person.
 

Matem?tico

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Mar 25, 2014
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Thanks, this is quite helpful. What is the copay per visit to primary care physician and to specialist under this plan? Paperwork or documents required to sign up?
 

mountainannie

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Dec 11, 2003
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This is a link to a pdf in English with all the details of the plan.

I have the Humano Max plan without maternity. It is RD$1600 per month, per person.

wow.. and were you the same guy that was bitcching about the overstay fee?

try getting USA coverage for that... more like $7000 US per person per year..

I pay US $200 a month here for my plan. But that is still cheaper than my Medicare co insurance would be

Co pays depend on the doctors.. which doctors accept which plans..and whether they charge above that.

so you will not know by reading any sort of brochure.

unless you are actually in the Capital or Santiago.. you will not have fast access to high end medicine

and some may argue that even the highest end medicine here is not comparable to the USA

leaders from the Island regualarly are reported to have gone to Miami for medical care

President Preval, of Haiti, went to Cuba.
 

mountainannie

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Dec 11, 2003
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they do seem to excell in liposuction and tummy tucks

as DV8 promotes her family physcians

for myself, I would never go undergo that for vanity

but ... well.. I would worry more about the level of education that you are going to get for your children and other stuff.

i have had very good medical service here.
 

dv8

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Sep 27, 2006
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copay depends on doctor's fee. it is a certain percentage rather than flat number. with plan max it should be 20%.
 

Matem?tico

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Yes, the outsider's perception of the best Dominican health care is that it is subpar-----my wife and elderly mother-in-law are afraid of exposure to deficient care. However, aren't there many Dominican physicians trained in the US and in other 1st world medical schools? And I was completely surprised when I read about the current Dominican president leaving to be treated in Florida recently. What a slap in the face of your country's medical system and its professionals.
 

mountainannie

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sorry, DV,, but down here in the Capital.. it pretty much depends on what the market will bear

if a doc can get $2k from a gringo , s/he will\

\i once had a so called dermotologist

who then sold me $8000 pesos worth of product

you are speaking from an insiders perspectives

the medical system here is just as crooked as the rest .. unless you are actually
IN Patient IN side a hospital of standing

or.. like yourself

an insider..

caveat emptor
 

mountainannie

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Yes, the outsider's perception of the best Dominican health care is that it is subpar-----my wife and elderly mother-in-law are afraid of exposure to deficient care. However, aren't there many Dominican physicians trained in the US and in other 1st world medical schools? And I was completely surprised when I read about the current Dominican president leaving to be treated in Florida recently. What a slap in the face of your country's medical system and its professionals.

no American trained physician would come here to practice.
There is not enouogh money in it.

it goes the other way..

yes that is it.. the PRESIDENT leaves

your wife and mil are right to be concerned..

as well as being exposed to diseases that have long been eradicted in the USA

plus some that have not hit there.. like chikungunya

there are a few doctors here who have trained in europe.. like france or spain or argentina

and i have one who is at least board certified in the USA and that is certainly very very rare

you will only find USA standards of cleanliness in the best hospitals

you will NOT find USA nursing care ANYWHERE here

nursing care here is .. well.. pretty much delegated to family who are supposed to move into the hospital with you

i mean, even into Hospiten or Clinic Abreu here in the Capital that is the case
 

dv8

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Sep 27, 2006
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MA, the question was about the copay for a simple visit which is 20% with plan max. that's regardless of being a gringo or not.
 

dv8

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Yes, the outsider's perception of the best Dominican health care is that it is subpar.

there are certain things that are better here than in europe. any specialist is available, at any time, with no wait. there is no wait for tests either. you go to a neurologist in the morning, he send you for tomography, you get results next day, turns out to be a tumor, the consult with the oncologist is the same day and surgery can take place a day later.

downside is the fact that there seem to be no appointments. so while you don't need to wait weeks to see a specialist you need to sit for two hours in awaiting room.

i only had one serious health issue here that ended in a surgery and i have zero complains. i would not choose DR specifically for health care but since i live here i make the best of what is available.
 

whirleybird

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Feb 27, 2006
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I am not going to post the actual figures/ costs here but, back in the summer of 2008, my husband was treated at Union Medica in Santiago having been referred there from Bournigal in POP. The specialist was very smart, seemed to be efficient, made only a totally bad diagnosis and charged a fortune in fees (only a part of which was covered by our insurance).
 

notreallyconfused

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Feb 18, 2013
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MA, the question was about the copay for a simple visit which is 20% with plan max. that's regardless of being a gringo or not.

I PAY 16,450 PESOS EVERY 3 MONTHS. MY PLAN IS HUMANO PLATINUM. EVERY DOCTOR IS DIFFERENT. SOME CHARGE ME NO COPAY. SOME 500 PESOS. It covers 15000 in prescription yearly. I was in the hospital several times and I paid nothing. Had tests done, and paid nothing. For me it's piece of mind more than anything.
 

dv8

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Sep 27, 2006
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yes. also some plans have limits in the copay if the total fee is over certain amount. there would also be other costs involved. a visit to gynecologist may be a simple check up but it may also include pap smear.