Citizenship and SeNaSa

[william webster]

I learned something very important yesterday.

I was getting some things sliced off my face in POP.. a derma..in Pto Plata

If, if , if, I get where I don't want to be..... it will be surgery, not an office visit.

My Int'l insurance has me 'pre-existing' for skin cancers.... self pay

She said (knowing I was a citizen)
Let's look up your SeNaSa coverage....

Yup, I have it !! What a surprise !!

citizens over 60 are auto covered.. !!
I have never reg'd !! Never applied.... nuttin'

What a deal !!
All free !!!

That's an advantage of citizenship - especially for older people

 

[NALs]

Well, it isn't free, free. Think of it as getting something back from all the ITBIS (since January 1 is called VAT) tax and all the other taxes you paid to the Dominican government through the years. Yes, a not so nice chunk passes next to you on all sorts of Jeepetas while on Dominican roads, but some is actually coming back in other ways. The money has to come from somewhere.

Don't know if it's up yet, but last year the process of creating a SeNaSa product for Dominican citizens living in the USA supposedly was starting. Their plans are not free though, but will be the cheapest option of all the medical insurances in the USA (except medicare if someone qualifies to get it for free). It's not clear if this medical insurance is to cover medical needs in the USA only, in the DR only or in both.

 

[william webster]

It will pay for my cataract surgery - I checked today......

Yahooeee!!!

 

[El Hijo de Manolo]

It will pay for my cataract surgery - I checked today......

Yahooeee!!!

Yep and youre better off with me doing the surgery

 

[william webster]

I am learning about this....

People like me - no employer - need apply for the Larimar plan

Cost is about 20,000 DOP/yr - if over 70, double that

 

[william webster]

My friend actually dug up the real goods


https://www.arssenasa.gob.do/index.php/plan-larimar/

SeNaSa Larimar is the health insurance offered to Dominicans, foreigners (nationals or with a passport) who wish to acquire an independent plan, as well as, for the Dominican diaspora that permanently returns or wants to obtain medical coverage for their family in the country.

With this plan, SeNaSa offers its volunteer members (individual and family) an excellent quality / price ratio, with a wide catalog of more than 3,000 health services provided through a national network of about 8,000 doctors, clinics, laboratories and private diagnostic centers.

Requirements
Complete the membership form.
Copy of the identity card (adults).
Copy of the birth certificate (minors).
Copy of the marriage certificate or the certificate of free union.
Make the previous payment according to the selected period (quarterly, semi-annual or annual).
Applicants aged 55 and over must have a medical check-up.
Coverage
Medical consultations: unlimited, payment of differences applies.
Psychological and psychiatric consultations: 80% up to RD $ 3,000 per year.
Laboratories, X-rays and special studies: 80%, according to the coverage catalog of this plan.
Outpatient procedures: 80% on List of Medical Fees (LHM) *.
Emergency services: 100% in contracted centers.

Room: 100% up to RD $ 3,000 daily, for an unlimited period.
Medications in detention: 100% up to RD $ 3,000 daily, for an unlimited period.
Intensive care room: 100% up to RD $ 5,000 daily, for an unlimited period.
Surgery room: 100%.
Anesthesia and consumable material: 100%.
Medical fees: 100%.
Laboratories and X-rays: 100%.
Limit per case: RD $ 250,000.

 

[El Hijo de Manolo]

My friend actually dug up the real goods


https://www.arssenasa.gob.do/index.php/plan-larimar/

SeNaSa Larimar is the health insurance offered to Dominicans, foreigners (nationals or with a passport) who wish to acquire an independent plan, as well as, for the Dominican diaspora that permanently returns or wants to obtain medical coverage for their family in the country.

With this plan, SeNaSa offers its volunteer members (individual and family) an excellent quality / price ratio, with a wide catalog of more than 3,000 health services provided through a national network of about 8,000 doctors, clinics, laboratories and private diagnostic centers.

Requirements
Complete the membership form.
Copy of the identity card (adults).
Copy of the birth certificate (minors).
Copy of the marriage certificate or the certificate of free union.
Make the previous payment according to the selected period (quarterly, semi-annual or annual).
Applicants aged 55 and over must have a medical check-up.
Coverage
Medical consultations: unlimited, payment of differences applies.
Psychological and psychiatric consultations: 80% up to RD $ 3,000 per year.
Laboratories, X-rays and special studies: 80%, according to the coverage catalog of this plan.
Outpatient procedures: 80% on List of Medical Fees (LHM) *.
Emergency services: 100% in contracted centers.

Room: 100% up to RD $ 3,000 daily, for an unlimited period.
Medications in detention: 100% up to RD $ 3,000 daily, for an unlimited period.
Intensive care room: 100% up to RD $ 5,000 daily, for an unlimited period.
Surgery room: 100%.
Anesthesia and consumable material: 100%.
Medical fees: 100%.
Laboratories and X-rays: 100%.
Limit per case: RD $ 250,000.

Not bad on the room coverages! I would be interested to see the docs and facilities that pop up on the coverage list though. Psych coverage only up to 3000 year - you'll be through that in 20 min

 

[william webster]

Actually, if you look at other plans - employee plans - the room quotient is low
Goes as high as $6,000 daily on the premium plan

 

[bienamor]

Applicants aged 55 and over must have a medical check-up.
Coverage

Have a hunch that previous problems will not be covered! example Heart, blood pressure etc. Or you won't qualify for coverage at all. Plus I think your list of facilities will all be public hospitals!

 

[El Hijo de Manolo]

Applicants aged 55 and over must have a medical check-up.
Coverage

Have a hunch that previous problems will not be covered! example Heart, blood pressure etc. Or you won't qualify for coverage at all.

not as thorough as the States when looking for pre existing conditions. There's no medical records database or HIPAA. Maybe developing, but certainly not where I've been. I go for an exam and come out with perfect BP, but they have no idea I take 3 different meds to control it (example). The list goes on

 

[NALs]

It shouldn't be assumed that all public hospitals are bad and the public hospital system has gone through improvements in recent decades. The general hospital in Plaza de la Salud (that hospital is like a private clinic), all hospitals in Ciudad de la Salud are two examples of public hospitals in excellent shape and with quslity health care. The Mendoza Hospital (I think is pediatric) recently was declared as one of the best of its type in Latin America and that too is public.

The days of widespread lacking of medicines, dip, etc are over in many public hospitals.

 

[JD Jones]

Applicants aged 55 and over must have a medical check-up.
Coverage

Have a hunch that previous problems will not be covered! example Heart, blood pressure etc. Or you won't qualify for coverage at all. Plus I think your list of facilities will all be public hospitals!

Senasa is for people who have a hard time or are not able to find insurance at all. So far I have not heard of anyone being turned away

 

[william webster]

from the SeNaSa customer service e-mail about applying
it say says 75yrs and older pay double

Dear, To join our voluntary plan, SeNaSa Larimar, you must contact one of our offices and meet the following requirements: • Complete the membership form. • Copy of the identity card (adults). • Make the previous payment according to the selected period (quarterly, semi-annual or annual). • Applicants aged 55 and over must have a medical check-up. • From the age of 75, you pay double the premium. From the age of 85 it triples - Forms of payments -Quarterly -Semestral -Annual - Cost of the Larimar Plan -Quarterly Premium: RD $ 5,241.00 -Semester Premium: RD $ 10,482.00 -Annual Premium: RD $ 20,964.00. These costs are individual, per person. You can check more information through our page www.arssenasa.gob.do Pleasure to serve you!

 

[JD Jones]

from the SeNaSa customer service e-mail about applying
it say says 75yrs and older pay double

Dear, To join our voluntary plan, SeNaSa Larimar, you must contact one of our offices and meet the following requirements: • Complete the membership form. • Copy of the identity card (adults). • Make the previous payment according to the selected period (quarterly, semi-annual or annual). • Applicants aged 55 and over must have a medical check-up. • From the age of 75, you pay double the premium. From the age of 85 it triples - Forms of payments -Quarterly -Semestral -Annual - Cost of the Larimar Plan -Quarterly Premium: RD $ 5,241.00 -Semester Premium: RD $ 10,482.00 -Annual Premium: RD $ 20,964.00. These costs are individual, per person. You can check more information through our page www.arssenasa.gob.do Pleasure to serve you!

20K for annual medical insurance. I'm surprised people are not moving here just for the insurance costs.

 

[william webster]

good coverage too

 

[DR fan1990]

I'm confused. I thought Senasa was restricted to Dominican nationals or people with a cédula only??
I mean it's called NATIONAL healthcare after all (SEguro NAtional de SAlud).

So any tourist and expat can apply for this coverage and get enrolled?

 

[JD Jones]

I'm confused. I thought Senasa was restricted to Dominican nationals or people with a cédula only??
I mean it's called NATIONAL healthcare after all (SEguro NAtional de SAlud).

So any tourist and expat can apply for this coverage and get enrolled?

Yes.

 

[XTraveller]

I am learning about this....

People like me - no employer - need apply for the Larimar plan

Cost is about 20,000 DOP/yr - if over 70, double that

Yes and recently check Cedimat takes this plan, pays well for DR. Appointments and procedures(Scan,xrays, sono....). Small converge for medicine.

 

[Northern Coast Diver]

Most well known private clinics accept Senasa. The list of facilities is impressive.

 

[windeguy]

Most well known private clinics accept Senasa. The list of facilities is impressive.

Most well known private clinics do not accept the basic Senasa provided for free to DR Citizens.
At least those on the north coast do not from personal experience on checking them.

I suspect many clinics accept SENASA plans you must pay for out of pocket.
Paid Plan Larimar might be an option for those otherwise uninsurable through non-government insurance plans.
They just need a passport and a pulse. (Despite saying a Cedula number is needed, so perhaps that is not true? )

Plan Larimar - ARSSeNaSa

¿Qué es SeNaSa Larimar? SeNaSa Larimar es el seguro de salud ofertado a dominicanos, extranjeros (nacionalizados o con pasaporte) quienes desean adquirir un plan independiente, así como, para la diáspora […]

www.arssenasa.gob.do