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Health insurance - Updated Info 2006
I have health insurance in the DR. It is good and it is bad.
Good: I can go in and see their doctors, and if they accept my insurance, it only costs me RD$20 a visit. They have 2 hospitals/clinics to go to in Santo Domingo, as well as clinics throughout the country which also accept this insurance as payment. Also includes ambulance coverage.
Good: the cost of the insurance is only about RD$10,500 a year for family coverage. In the US it would be US$10,000 a year for equivalent coverage AND a hell of a lot of paperwork for every claim.
Good: It pays 100% of vaccinations and lab work.
Good: No paperwork, we just show our carnet and pay RD$20.
Bad: the really good, experienced doctors in their own hospitals don't accept payment from this insurance, and I end up paying the Doctor from RD$500 to $700 a visit if I want to see the best doctor, (in my definition, one who has a second medical specialty degree from Espa?a or Argentina or the US, and 10 to 20 years experience and a wall full of medical books thrown in as well).
Bad: It does NOT cover catastrophic medical events. You have to buy a second catastrophic policy with a deductible for things like cancer, heart trouble, liver transplant, etc, or the alternative for you will be to go home and lay on the couch in your house and die slowly without treatment after your cash runs out.....
Bad: We went in on a Sunday as an emergency visit. I ended up paying for the majority of the labwork (this would have been free if we had waited until Monday, but that didn't seem appropriate); I paid for the Doctor on duty's fee, as he didn't accept the insurance, and the deductible for the call as well. Might as well not have had insurance for that visit.
Bad: A lack of accurate information in writing for our policy. You just have to go to the clinic or the doctor, and find out how much and what is covered, and pay the difference immediately.
Good luck.
Good: I can go in and see their doctors, and if they accept my insurance, it only costs me RD$20 a visit. They have 2 hospitals/clinics to go to in Santo Domingo, as well as clinics throughout the country which also accept this insurance as payment. Also includes ambulance coverage.
Good: the cost of the insurance is only about RD$10,500 a year for family coverage. In the US it would be US$10,000 a year for equivalent coverage AND a hell of a lot of paperwork for every claim.
Good: It pays 100% of vaccinations and lab work.
Good: No paperwork, we just show our carnet and pay RD$20.
Bad: the really good, experienced doctors in their own hospitals don't accept payment from this insurance, and I end up paying the Doctor from RD$500 to $700 a visit if I want to see the best doctor, (in my definition, one who has a second medical specialty degree from Espa?a or Argentina or the US, and 10 to 20 years experience and a wall full of medical books thrown in as well).
Bad: It does NOT cover catastrophic medical events. You have to buy a second catastrophic policy with a deductible for things like cancer, heart trouble, liver transplant, etc, or the alternative for you will be to go home and lay on the couch in your house and die slowly without treatment after your cash runs out.....
Bad: We went in on a Sunday as an emergency visit. I ended up paying for the majority of the labwork (this would have been free if we had waited until Monday, but that didn't seem appropriate); I paid for the Doctor on duty's fee, as he didn't accept the insurance, and the deductible for the call as well. Might as well not have had insurance for that visit.
Bad: A lack of accurate information in writing for our policy. You just have to go to the clinic or the doctor, and find out how much and what is covered, and pay the difference immediately.
Good luck.
I second HB's advice: use an insurance broker in the area you live in, to find the policy that will best meet your needs at the price you are willing to pay. Many clinics offer their own insurance, as well as many private doctors, and the broker will know the medical facilities available and their reputations.
Carlos
How much does a better plan cost for an individual that would cover catastropic events?For example,if my appendix explodes and I have to be operated upon and liad up in the hospital for a week.How much would a plan such as this cost?Of course I would like to be operated upon by a reputable doctor as well.
ILoveDR
(PS) I would want dental coverage as well
How much does a better plan cost for an individual that would cover catastropic events?For example,if my appendix explodes and I have to be operated upon and liad up in the hospital for a week.How much would a plan such as this cost?Of course I would like to be operated upon by a reputable doctor as well.
ILoveDR
(PS) I would want dental coverage as well
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Ask the insurance broker about their plans.
For me, I opted to have the major medical coverage for the US with a bigger deductible to cut the cost, thinking that if I or my family is faced with something major, I didn't want meatball surgery. I wanted the best facility and doctors who did that kind of thing every day, rather than making the front page of El Caribe and Hoy because they did the surgery here for the first time.
For me, I opted to have the major medical coverage for the US with a bigger deductible to cut the cost, thinking that if I or my family is faced with something major, I didn't want meatball surgery. I wanted the best facility and doctors who did that kind of thing every day, rather than making the front page of El Caribe and Hoy because they did the surgery here for the first time.
A good one
Let me recomend Salud Total, S.A. i have the xxx plan which includes, dentist, optic & most important movimed service I pay 1200 per bimester for me & my girlfriend.
Plus in case of an emergency in a non member hospital they pay u back the 60% like in Hospiten.
Let me recomend Salud Total, S.A. i have the xxx plan which includes, dentist, optic & most important movimed service I pay 1200 per bimester for me & my girlfriend.
Plus in case of an emergency in a non member hospital they pay u back the 60% like in Hospiten.
years ago health insurance premiums seemed very affordable with fantastic coverage to match. see http://www.insurancepaylite.com check how insurance companies price:bunny: well, if you're an individual or family who pays for health insurance today chances are you're literally getting punched in the pocket book, and it hurts.
This is a really old thread but it can do with an update. Anyone out there with more current information on Health Insurance in the DR?
Currently I am covered by ARS PAlic Salud. Single coverage costs RD$540/month. Covers Hospital and Inpatient Charges 100%, Doctor visit w/50 co-pay, 80% prescriptions up to RD$3,000/year, 80% Dental, 80% Outpatient Lab and X-Ray, 100% Emergency Room, etc. Maximum coverage is RD$300,000/year. I recently was in Centro Medical Bournigal for 5 days and my total out-of-pocket cost was RD$300 for services not covered. Although RD$300,000 is not a great deal of coverage in case of a major illness, I figure it would be adequate until I could arrange transport back to the US.
additional insurance
Like Howmar I too have the ARS Palic insurance which covers me for everything .......here. I translate everything into US so here in the DR I am covered for a max of US $15,000. Here that coverrs just about everything and pretty much all surgeries etc. Then I bought an international policy that covers me for up to I think US $1,000,000, in case I need heart surgery, knee surgery or......., and the circumstances are that it is elective enough that I can choose to have it here or in the US.
If you want complete details, I can put you in touch with my agent.
JRR
Like Howmar I too have the ARS Palic insurance which covers me for everything .......here. I translate everything into US so here in the DR I am covered for a max of US $15,000. Here that coverrs just about everything and pretty much all surgeries etc. Then I bought an international policy that covers me for up to I think US $1,000,000, in case I need heart surgery, knee surgery or......., and the circumstances are that it is elective enough that I can choose to have it here or in the US.
If you want complete details, I can put you in touch with my agent.
JRR
There are very good plans available here, and for a fraction of the cost of equal plans in the States. However, one thing I didnt see mentioned on this thread, but needs to be said, is that unlike plans in the States, medications here are not covered. If you are on a company plan, apparently the medications will be covered, but individual plans do not do this.
That is a significant hole, becuase medications here are very expensive, and if you need to take something for a chronic condition, you may find that paying for it will be quite costly (if the medication is even available).
The best Pharmacy in the capital is San Judas Tadeo on av. Independencia, and if they dont have it, it probably cannot be got. So you will have to arrange for someone to ship you what you need.
That is a significant hole, becuase medications here are very expensive, and if you need to take something for a chronic condition, you may find that paying for it will be quite costly (if the medication is even available).
The best Pharmacy in the capital is San Judas Tadeo on av. Independencia, and if they dont have it, it probably cannot be got. So you will have to arrange for someone to ship you what you need.
cost of policies
Good point about the prescriptions n ot being covered here.......
The local policy runs me $940 pesos a month, that's health, dental, and optical. My other policy has a deductible ( I think $10,000 ) and costs about US $3200/year. I can have no deductible, but I figured it would take me about 7.5 years to self insure the deduc tible. That's still a whole lot less than I paid in the states.
When I was in the states, and indured just my brother and his family and mine, with Guardian, it cost me $23,000. per year! Came in handy as my first wife had scoliosis surgery........bill was $36,000 for the doctor. Insurance and he settled on $18,000.....don't you just love it? Funny thing is later on when I closed my business I got my life and health insurance licenses in NY, NJ and Ct., and wrote policies for Guardian.
JRR
rellosk said:
Good point about the prescriptions n ot being covered here.......
The local policy runs me $940 pesos a month, that's health, dental, and optical. My other policy has a deductible ( I think $10,000 ) and costs about US $3200/year. I can have no deductible, but I figured it would take me about 7.5 years to self insure the deduc tible. That's still a whole lot less than I paid in the states.
When I was in the states, and indured just my brother and his family and mine, with Guardian, it cost me $23,000. per year! Came in handy as my first wife had scoliosis surgery........bill was $36,000 for the doctor. Insurance and he settled on $18,000.....don't you just love it? Funny thing is later on when I closed my business I got my life and health insurance licenses in NY, NJ and Ct., and wrote policies for Guardian.
JRR