Doctors versus health care providers

Dolores

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A reader of these lines has probably experienced the effects of the dispute between the Dominican Medical Association (CMD) and other medical professional entities and the Health Services Administrators known as ARS or the local HMOs in the Dominican Republic.

The dispute has resulted in health insurance holders being denied services by physicians, hospitals and other services over the past months. In other cases, insurance companies have reimbursed the patients.

The CMD struggle is about getting the ARS to update their pay schedules, modernize their lists of medicines and procedures and ease some of the restrictions. For instance, if a pharmacy does not have the meds the company prescribed, the pharmacy will not accept the insurance plan coverage for a different brand.

The list is long, but Dr. Senen Caba, the current head of the Dominican Medical...

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RDKNIGHT

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Mar 13, 2017
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health providers have lost their minds greed has set in. they wanted to charge me double from last year after I didn't put one claim in . I told them you must be nuts and to stick it where the sun don't shine
 
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JD Jones

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Keep in mind they are doing what they are doing only to make more money. Nothing to do with helping patients.
 
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Drperson

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health providers have lost their minds greed has set in. they wanted to charge me double from last year after I didn't put one claim in . I told them you must be nuts and to stick it where the sun don't shine
what insurance company charges double with no claims?It is maybe age related.
 

aarhus

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humano even with age that is criminal
I am beginning to think Humano isnt so great. It looks all very professional though. Despite having moved back to Denmark I kept my last insurance with them which is a very basic one.
 

Drperson

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I am beginning to think Humano isnt so great. It looks all very professional though. Despite having moved back to Denmark I kept my last insurance with them which is a very basic one.
many of our customers reduce their coverage while they are away then increase it when they come back , to avoid waiting periods for some things.Our experience in dealing with humano has always been very professional and good.
 

aarhus

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Jun 10, 2008
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many of our customers reduce their coverage while they are away then increase it when they come back , to avoid waiting periods for some things.Our experience in dealing with humano has always been very professional and good.
I decided to keep it at least as long I plan to still come a couple of months a year to the DR. It does make it easier when you need to see a doctor to have a local insurance and Humano don’t require you to be a resident of the DR.
 

RDKNIGHT

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So you are saying that the premiums increased after 70 years . As I understand it all insurance companies increase as people get older. I am sure this is based on highter risk . Otherwise the younger people would subsidize the older people.
im not close to 70 55 is the age ...
 

hedon

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Mar 26, 2008
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I decided to keep it at least as long I plan to still come a couple of months a year to the DR. It does make it easier when you need to see a doctor to have a local insurance and Humano don’t require you to be a resident of the DR.
I was read this because I am thinking about living in DR for 6 months during the year. Do you happen to know what it cost there to get health insurance for people over 70--if you can get it al all?
 

aarhus

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Jun 10, 2008
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I was read this because I am thinking about living in DR for 6 months during the year. Do you happen to know what it cost there to get health insurance for people over 70--if you can get it al all?
I know nothing about that. You could ask Drperson here on the forum
 

JD Jones

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Jan 7, 2016
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I was read this because I am thinking about living in DR for 6 months during the year. Do you happen to know what it cost there to get health insurance for people over 70--if you can get it al all?
Yes, you can get insurance from SENASA, the govt insurance plan. Specifically their plan Larimar.

 

Drperson

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Sep 19, 2008
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Yes, you can get insurance from SENASA, the govt insurance plan. Specifically their plan Larimar.

With Senasa the policy limit is only 250,000 pesos so it doesn't cover major events. Ok though for making lab tests and doctors visits cheaper.