Expats & Dominican Insurance

What Dominican insurance company do you use for medical insurance?

  • Universal

    Votes: 5 27.8%
  • Humano

    Votes: 8 44.4%
  • Palic

    Votes: 2 11.1%
  • SeNaSa (Government)

    Votes: 0 0.0%
  • Futuro

    Votes: 0 0.0%
  • Monumental

    Votes: 1 5.6%
  • Meta Salud

    Votes: 0 0.0%
  • Medicard

    Votes: 0 0.0%
  • Another Company

    Votes: 1 5.6%
  • I don't have health insurance.

    Votes: 1 5.6%

  • Total voters
    18

NALs

Economist by Profession
Jan 20, 2003
13,510
3,202
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Insurance is a fact of modern life and the DR isn't the exception. There are many types of insurances, but the main focus in this thread is medical insurance. Votes are private.

What Dominican insurance company do you use for medical insurance?

Feel free to explain any good or bad experiences with any Dominican insurance company, which do you recomend and/or which you don't, if any change was done between insurance companies, etc.
 

JD Jones

Moderator:North Coast,Santo Domingo,SW Coast,Covid
Jan 7, 2016
11,878
8,262
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Do you want to know which company to use? Ask the people who deal with insurance companies every day.

These days Humano and Palic seem to be tied for 1st place with Universal a very close second.

Universal used to be the golden standard (IMHO). I've been with them since the mid 80's.

These days they have an aggravating habit of sending someone to visit you to see how sick you really are if you are in the hospital and pressuring doctors to discharge you but I'm sure the other companies probably do the same.
 

Drperson

Well-known member
Sep 19, 2008
1,078
296
83
the bigger problem is not that your insurance company but the secretaries at clinics who say the insurance is inactive so you pay cash they pocket the cash and claim the money from the insurance.
YOU need to have a representative from the company that sold the policy to go to bat for you and call the clinic/hospital to resolve the problem. If you pay cash always get a signed receipt.
 

JD Jones

Moderator:North Coast,Santo Domingo,SW Coast,Covid
Jan 7, 2016
11,878
8,262
113
the bigger problem is not that your insurance company but the secretaries at clinics who say the insurance is inactive so you pay cash they pocket the cash and claim the money from the insurance.
YOU need to have a representative from the company that sold the policy to go to bat for you and call the clinic/hospital to resolve the problem. If you pay cash always get a signed receipt.

Where have you experienced that sort of behavior?
 

JD Jones

Moderator:North Coast,Santo Domingo,SW Coast,Covid
Jan 7, 2016
11,878
8,262
113
I don't have insurance except for Medicare A and B in the USA. Don't expect to change that.

So do I but I'll probably never use them. I'm a Vet so worst case I can go to the VA hospital in Miami. A royal PITA but as good as it gets.
 

JD Jones

Moderator:North Coast,Santo Domingo,SW Coast,Covid
Jan 7, 2016
11,878
8,262
113
Same here. Never thought about the VA hospital.
Gotta know how to play them. I don't go to VA unless I can show up at the emergency room as an "Emergency" and get seen almost immediately.

If not their process will make your life difficult. I understand the reason for it but it's very unfriendly for folks who don't live nearby.
 

Chirimoya

Well-known member
Dec 9, 2002
17,850
982
113
Humano. We used to be with Universal but they let us down badly so we switched.

Experience with Humano has generally been good. Recently we had an emergency admission and three-night hospital stay covered 100%. Not Covid.

One gripe - and this is not entirely the insurance company's fault - is that they only cover me to see a physiotherapist 50 km away when I have at least one here on my doorstep, so I end up paying out of pocket for the local physio because once you count the cost of travelling and time wasted, it's not worth it.

Note: health insurance is not "a fact of modern life." At least 30 countries in the world including the three I lived up to the age of 35 have excellent universal healthcare.
 
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Caonabo

LIFE IS GOOD
Sep 27, 2017
7,339
2,949
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Do you want to know which company to use? Ask the people who deal with insurance companies every day.

These days Humano and Palic seem to be tied for 1st place with Universal a very close second.

Universal used to be the golden standard (IMHO). I've been with them since the mid 80's.

These days they have an aggravating habit of sending someone to visit you to see how sick you really are if you are in the hospital and pressuring doctors to discharge you but I'm sure the other companies probably do the same.

I have never had an insurance company send a representative to a medical institution to either check on an employee, or myself.
This is disheartening to hear because most companies play the game of copying other's modules, and it may not be long before others attempt to follow suit. While there must be a need to monitor possible fraud occurring, invading the patient's privacy during trying times is not the solution. As well, pressuring facilities and/or doctors to release a patient prematurely is simply abhorrent.
There has been a reduction in time granted to a woman for recovery for a C-section birth. Whereas, a woman once would be granted five days, and than three days coverage from point of procedure, it is now down to as low as 36 hours.
For my employees and/or their respective spouses, I pay the difference from what the insurance policies will cover, and adding two extra days recovery time. For me this is purely a safety issue for the new mother, and I do not believe an insurance company or medical facility's financials should stand in front of a woman's health following childbirth.
 
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Meemselle

Just A Few Words
Oct 27, 2014
2,844
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In addition, I have Medicare/Medicaid and UHC in the US. Not leaving any tern unstoned.....
 

Caonabo

LIFE IS GOOD
Sep 27, 2017
7,339
2,949
113
the bigger problem is not that your insurance company but the secretaries at clinics who say the insurance is inactive so you pay cash they pocket the cash and claim the money from the insurance.
YOU need to have a representative from the company that sold the policy to go to bat for you and call the clinic/hospital to resolve the problem. If you pay cash always get a signed receipt.

While I have never had this direct situation play out, which a secondary inquiry should be quick to resolve, I did have something similar happen to me just this past week at a pharmacy branch I frequent. I was told my coverage would not pick up a prescription's cost due to me having exceeded my annual cost limitations for medications included in my policy.
This was clearly an error, but the pharmacy branch representative would not hear anything of it. I removed my prescription and myself to another pharmacy chain branch, and said medication was approved and purchased within 10 minutes. The following day I consulted with my provider, and as believed, I was nowhere near the annual limitation amount for medications.
While I will not be quick to judge the earlier representative on fraud or possible theft, I will 100% state that it had more to do with inexperience and poor customer relation skills.
 

JD Jones

Moderator:North Coast,Santo Domingo,SW Coast,Covid
Jan 7, 2016
11,878
8,262
113
I have never had an insurance company send a representative to a medical institution to either check on an employee, or myself.
This is disheartening to hear because most companies play the game of copying other's modules, and it may not be long before others attempt to follow suit. While there must be a need to monitor possible fraud occurring, invading the patient's privacy during trying times is not the solution. As well, pressuring facilities and/or doctors to release a patient prematurely is simply abhorrent.

That you know of......
 
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NALs

Economist by Profession
Jan 20, 2003
13,510
3,202
113
While I have never had this direct situation play out, which a secondary inquiry should be quick to resolve, I did have something similar happen to me just this past week at a pharmacy branch I frequent. I was told my coverage would not pick up a prescription's cost due to me having exceeded my annual cost limitations for medications included in my policy.
This was clearly an error, but the pharmacy branch representative would not hear anything of it. I removed my prescription and myself to another pharmacy chain branch, and said medication was approved and purchased within 10 minutes. The following day I consulted with my provider, and as believed, I was nowhere near the annual limitation amount for medications.
While I will not be quick to judge the earlier representative on fraud or possible theft, I will 100% state that it had more to do with inexperience and poor customer relation skills.
The representative has been lied to on numerous occasions by customers. After a while, any excuse by any customer is seen as a lie and treated as such. It happens alot in positions that require a near constant contact with the public. A person can start the position with a more normal attitude and in a matter of months, sometimes weeks, their attitude in this regards changes and they become like that representative. I have seen it happen numerous times.
 

aarhus

Long live King Frederik X
Jun 10, 2008
4,412
1,987
113
I have Humano with an international part which is United Health Care but I am currently looking into if the international part is worth it. I don’t go much to the US anymore and not sure if it really is that international outside NA as I plan to travel more back to Europe and later check out Asia.
 

Andre14615

Banned
May 31, 2019
488
389
63
To my veterans you guys don't go to the third-party veteran clinic in Santo Domingo? It's pretty good
 

JD Jones

Moderator:North Coast,Santo Domingo,SW Coast,Covid
Jan 7, 2016
11,878
8,262
113
To my veterans you guys don't go to the third-party veteran clinic in Santo Domingo? It's pretty good

No. I'm not convinced I have any use for the services they offer. Are you a veteran? Do you use them?
 

Drperson

Well-known member
Sep 19, 2008
1,078
296
83
Where have you experienced that sort of behavior?
we get calls from our clients every 2 or three days. It drives us crazy as the people are very upset and it takes some time to sort things out with the clinic . The insurance is never a problem