Does this discussion about gringos getting insurance assume the person has a cedula and is a legal Resident? snow birds are s-out-of-luck?
Insurance for nonresident foreigners in this country can be a tricky thing. There are those who have had issues and those that have had not when they need to use their insurance. Speaking strictly about health insurance, all of the policies have a yearly limit. How much that is depends on the coverage you buy. I suspect that for many, if presented with a serious or ongoing illness, they will initially diagnose and begin treatment here but will scurry home for continuing care or the ultimate surgical resolution. Some treatments the DR does well enough, others not so much. For example in the case of some cancers the diagnostics and treatment options are a bit behind the times and more robust options exist back home. Those who live in or close to Santiago/Santo Domingo have easier access to the best medical care available here. Those who live further away, need to accept that travel to these places may be in their future for anything above and beyond routine medical care.
Snowbirds by definition for the most part probably don't need or want medical insurance here because they have whatever they have at home. Canadians, can be out of the country for six months before their provincial healthcare plan ceases to provide coverage. Snowbirds who are in the DR for more than six months, really aren't snowbirds. In some jurisdictions insurance providers insist that other policies be used up before theirs kicks in. The last thing you need to deal with when you are ill or injured is a debate between multiple insurers as to who is considered the primary insurer.
I have been fortunate in that I haven't needed to use my top tier Universal insurance yet and I hope it remains that way. Like everything else, prices for various plans differ widely from provider to provider as do the details of coverage. How much coverage you purchase can rather quickly become a significant factor when it comes to treatment. I know of a case where the insurance ran out before the patient was fully recovered (in fact before they regained full consciousness) and they woke up in a different hospital than the one they originally checked into because the money ran out.
If you are able to purchase at your advanced age, expect decent coverage to be more expensive than for someone in their early sixties. Expect the cost to go up every year at renewal time, do not let it lapse as you likely won't be able to get coverage again anywhere in this country, and choose that coverage wisely within the scope of options you are presented with. Being very ill or very broken and having to deal with payment issues to continue treatment is sometimes next to impossible.
Everyone should have someone who has power of attorney here in the DR to speak for them with respect to treatment issues when you can't do that yourself and someone who has quick access to money. Even with money in the bank, if your credit card tops out mid treatment and you still aren't ambulatory, you could easily find yourself in a predicament.
Good luck in your search, expect to pay a premium for any insurance you find. Be sure you understand exactly what you are buying. Policies here are in Spanish and contain "legalese" just like at home and for a nonnative speaker can be hard to translate accurately and therefore understand. All of the tricks used at home by insurance companies to deny or limit coverage can and do come into play here with local insurers. No local policies that a I know of cover medical repatriation. If you find yourself hospitalized and unable to travel on a commercial flight home, you're stuck here unless you have the means to secure your own air ambulance.
In many third world countries a lot works and a lot doesn't. The DR is no exception. Insurance coverage here is usually limited for at least a year sometimes two for new policies. The list of preexisting condition exclusions is long and sometimes complicated. You cannot rely on the verbal assurances of the person selling you the policy.
If it isn't in the policy, in writing, it isn't and won't be covered. Preexisting conditions often have coverage implications beyond what a layperson assumes to be the case. If you need medical insurance here, get the best coverage you can find, afford and then have a backup plan for when it all goes to pot and you have to bail. If you are not a legal resident in this country, scour the policy very carefully for any language that would preclude or limit coverage. As always, pay close attention to all the clauses that limit your coverage based on participating in "adventure/extreme" activities and check with any insurer you have at home to see what they can and will do for you while you are snowbirding in the DR.
Best of luck.