Learned something about Humano insurance

Neargale

Active member
Jul 4, 2013
347
67
28
All the threads on health care in the DR prompted me to write about my experience with Humano.

I have the Platinum plan, the most expensive. Hubby has the Royal Plan, less expensive, still with Humano.

We went to our dentist in Puerto Plata who takes Humano. We both had a cleaning. Our individual bill which was done separately came up to about the same price. I thought that a more expensive plan would cover more than a less expensive plan. In this case, yes it does but the dentist only deals with the least expensive plan so that was what the billing reflected. Nobody had told me that. I foolishly thought that if somebody takes Humano they take all levels of Humano. Not so and they don't tell you! Of course the bill is not itemized!

All hope of getting what I pay for is not lost. I have to submit my bill to Humano and they will apparently issue a reimbursement based on the difference between the plan Royal and my Plan Platinum. What gets me is... in the last 5-6 years I Have gone to a number of dentists or doctors or specialists, most of them took Humano. At which level was I reimbursed? Who knows!!!

The solution is to get a list of the dentists/doctors who are part of the Humano network and specifically take Platinum. No, it is not on the web. It took close to 1 month to get that list of dentists. They forgot to request the list of doctors too. One would presumably also double check with the doctors office and ask whether Platinum is still covered so one knows whether to ask for a reimbursement. While the price difference on a dental cleaning is not that much (about 900 pesos) the price difference on a crown is a lot more (25K just for the crown, not including a root canal).

The quality of health care may be good IF you find the right doctor (thanks to Hillbilly and dr1) but you also need to learn to navigate the insurance system.
 

william webster

Platinum
Jan 16, 2009
30,247
4,328
113
Yes - Humano is complicated

I have group of 11 on it....
one level includes their children - another does not.

Some doctors accept some plans - some do not.
All 11 are Dominicans and THEY are confused.

I told them to call Humano first and get advice where to go....
who takes it for estudios and so on....

A bit of a maze the RD insurance game
 

chico bill

Dogs Better than People
May 6, 2016
12,543
6,307
113
Reduce your level of plan to that of your husbands - make your savings there.
FYI submitting a non-itemized medical bill to Humano for reimbursement will result in them saying no can do.
Read the letter they send with their policy - it states that