D.R. Medical Insurance: Need Opinion

[Lucas61]

Happy Holidays to All! Be Safe!
I am at the very beginning of investigating D.R. medical insurance. A physican friend recommends I investigate either MAPFRE or Universal. I'm aware that physicians' labor actions may affect my choice. Based on your experience, any preference between these two or is there a third option? My status is "foreigner, non-resident."

 

[cavok]

I've always had Universal and am satisfied with their coverage and service. The physicians labor actions only affect consultations. With Universal, just submit the receipt and you will be reimbursed.

 

[bob saunders]

Happy Holidays to All! Be Safe!
I am at the very beginning of investigating D.R. medical insurance. A physican friend recommends I investigate either MAPFRE or Universal. I'm aware that physicians' labor actions may affect my choice. Based on your experience, any preference between these two or is there a third option? My status is "foreigner, non-resident."

Humano seems very popular, but I don't know if they have a plan to fit your age.

 

[Lucas61]

I've always had Universal and am satisfied with their coverage and service. The physicians labor actions only affect consultations. With Universal, just submit the receipt and you will be reimbursed.

Thank you for clarifying that the labor actions only affect consultations. Re: Universal, when you say that I will be reimbursed when I submit the receipt, that worries me! I want a policy that will cover me without my paying in advance, thus, no need to be reimbursed. More specifically, my situation is this: In the U.S. I have Kaiser Permanente Senior Advantage. Kaiser will reimburse me for urgent care and for emergencies here in the D.R. and I have confirmed that. I don't care about routine care or urgent care; I have cash for that. What I'm worried about is emergency care (e.g. ICU; surgery) for which I do NOT have enough cash in advance. In effect, I'm looking for a high deductible, say > RD$ 50,000, in which, if I needed surgery, let's say, I would not have to pay in advance. After the procedure, the insurance company here would be reimbursed by my insurance company in the U.S. Effectively, then, I am seeking a short term loan that allows me to receive emergency care without paying in advance when the fee is very large.

 

[Lucas61]

Humano seems very popular, but I don't know if they have a plan to fit your age.

Thank you. I will check Humano.

 

[cavok]

Thank you for clarifying that the labor actions only affect consultations. Re: Universal, when you say that I will be reimbursed when I submit the receipt, that worries me! I want a policy that will cover me without my paying in advance, thus, no need to be reimbursed. More specifically, my situation is this: In the U.S. I have Kaiser Permanente Senior Advantage. Kaiser will reimburse me for urgent care and for emergencies here in the D.R. and I have confirmed that. I don't care about routine care or urgent care; I have cash for that. What I'm worried about is emergency care (e.g. ICU; surgery) for which I do NOT have enough cash in advance. In effect, I'm looking for a high deductible, say > RD$ 50,000, in which, if I needed surgery, let's say, I would not have to pay in advance. After the procedure, the insurance company here would be reimbursed by my insurance company in the U.S. Effectively, then, I am seeking a short term loan that allows me to receive emergency care without paying in advance when the fee is very large.

As far as consultations go, you're looking at maybe 2000 pesos out of pocket. As far as I know, doctors are not accepting any of the insurance companies here when it comes to consultations. Universal pays 100% for emergency care admission and surgery.

 

[Lucas61]

As far as consultations go, you're looking at maybe 2000 pesos out of pocket. As far as I know, doctors are not accepting any of the insurance companies here when it comes to consultations. Universal pays 100% for emergency care admission and surgery.

For me, consultations, including urgent ones, are not a problem. I can easily pay cash for those and an insurance policy for those would be a waste of money. My concern is, What happens if I need emergency major surgery or need to go to the ICU and do not have enought cash up front?

 

[SKY]

Have not used my insurance in about a year or two, but I have had Monumental for close to 20 years and NEVER paid anything in advance for consultations or anything else other than the 20% fee..........My insurance covers 80%...........

 

[Lucas61]

Have not used my insurance in about a year or two, but I have had Monumental for close to 20 years and NEVER paid anything in advance for consultations or anything else other than the 20% fee..........My insurance covers 80%...........

That sounds good. Is Monumental in the D.R.? Website?

 

[bob saunders]

Thank you for clarifying that the labor actions only affect consultations. Re: Universal, when you say that I will be reimbursed when I submit the receipt, that worries me! I want a policy that will cover me without my paying in advance, thus, no need to be reimbursed. More specifically, my situation is this: In the U.S. I have Kaiser Permanente Senior Advantage. Kaiser will reimburse me for urgent care and for emergencies here in the D.R. and I have confirmed that. I don't care about routine care or urgent care; I have cash for that. What I'm worried about is emergency care (e.g. ICU; surgery) for which I do NOT have enough cash in advance. In effect, I'm looking for a high deductible, say > RD$ 50,000, in which, if I needed surgery, let's say, I would not have to pay in advance. After the procedure, the insurance company here would be reimbursed by my insurance company in the U.S. Effectively, then, I am seeking a short term loan that allows me to receive emergency care without paying in advance when the fee is very large.

They do take Credit Cards.

 

[Lucas61]

They do take Credit Cards.

LOL! Credit cards! That's what I'm trying to avoid! But, actually, it is a good point. If Kaiser is going to reimburse me anyway, then why not use a credit card in addition to debit card cash? Yes, something to think about.

 

[SKY]

That sounds good. Is Monumental in the D.R.? Website?

https://lamonumental.com.do/

 

[cavok]

For me, consultations, including urgent ones, are not a problem. I can easily pay cash for those and an insurance policy for those would be a waste of money. My concern is, What happens if I need emergency major surgery or need to go to the ICU and do not have enought cash up front?

Like I said in my post, Universal pays 100% for emergency room admission and surgery.

 

[Drperson]

Happy Holidays to All! Be Safe!
I am at the very beginning of investigating D.R. medical insurance. A physican friend recommends I investigate either MAPFRE or Universal. I'm aware that physicians' labor actions may affect my choice. Based on your experience, any preference between these two or is there a third option? My status is "foreigner, non-resident."

My wife is the number one seller of Humano Health Insurance on the north coast for the past 2 years. Humano sells more health insuirance policies than all the other non-governmental insurance companies COMBINED. There are no issues with the doctors at this time with Humano so they accept the insurance normally.
They are a very well run company and have monthly updates with their reps to update them and provide education. .
Myself having been in the medical manufacturing business for more than 20 years , and visiting hospitals , I learned to recognize a well run hospital from a poorly run one. It is always top down. When it is well run the staff function well as a team and have good moral.
We ie my wife's insurance company and Humano were also selected by the American Expeditionary Legion to provide exclusive health insurance plans for american veterans , and for veterans from all NATO members including Canada as well as for over 50 countries. We will also be providing these same benifits for police firefighters and first responders in these same countries including the Dominican Republic in the New Year. I hope this is helpful. Please do not hesitate to message me if you would like additional information or have any questions.

 

[keepcoming]

Thank you Drperson.

 

[cavok]

FWIW, apparently, not all doctors are going along with this action. I was at CMC in Sosua recently and Universal did cover the consultation as usual.

 

[Liberator]

Universal. Different types of insurance possible. Payment per month, quarter, year. Your credit card will be charged for the payments. A (small) deductible applies to some parts of the insurance.
Premium payment based on age. There will be a health check / acceptance

We used a consultant (target seguros) who explained everything extensively at our home (also speaks English) and compared the different policies with each other.

 

[JD Jones]

My wife is the number one seller of Humano Health Insurance on the north coast for the past 2 years. Humano sells more health insurance policies than all the other non-governmental insurance companies COMBINED. There are no issues with the doctors at this time with Humano so they accept the insurance normally.
They are a very well run company and have monthly updates with their reps to update them and provide education.

I have had Universal for decades. For many years they were the go-to best insurance to have. These days they can be very aggravating with their reps often pressuring doctors to discharge patients so they don't have to continue paying hospital bills.

If I had it to do over, I would have gone with Humano without a doubt, and I recommend them over Universal any day of the week.

 

[Drperson]

I have had Universal for decades. For many years they were the go-to best insurance to have. These days they can be very aggravating with their reps often pressuring doctors to discharge patients so they don't have to continue paying hospital bills.

If I had it to do over, I would have gone with Humano without a doubt, and I recommend them over Universal any day of the week.

i remember too about 15 years ago Universal was were the go to company