Health insurance for elderly Americans

Cdn_Gringo

Gold
Apr 29, 2014
8,672
1,133
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Matilda,

Buyer beware. Universal's stated position is that they won't issue coverage to anyone applying over the age of 64. I'm not aware that any of the big companies will either.

There used to be a guy who acted as a referrer for a commission and advertised cheap medical insurance in the Playa Magazine here in Sosua. I think he passed away within a year of me meeting him. That coverage cost less than 1/2 of what I was paying. When I checked into the Company further, and asked for reference clients, I was not referred to anyone who had been covered for anything more significant than a simple doctor's office visit, sprains, aches and pains. At the time my Spanish wasn't all that great but I could tell that the contract did not even come close to the coverage options offered by Universal. I passed on it despite the significant monetary savings.

At least for the time being, I would not be comfortable suggesting to anyone who is older than 63 that relocating to the DR to take advantage of cheaper medical care costs is feasible unless they have the means to fully fund their medical treatment themselves. Those that succeed in procuring insurance coverage here but need to file regular claims will find that their premiums rise quickly and eventually coverage will be withdrawn or capped at a limit that leaves a gap between the services they need and what the insurance will actually cover.

From those expats that I have spoken with, the insurance offered by the big boys here is ok to pretty good for those that need emergency care or treatment for one off injuries, infections and diseases. However, when one needs coverage for chronic conditions, even newly presenting conditions it doesn't take long for the insurance companies to try and limit or recoup their ongoing expenditures. Like insurance everywhere, the best coverage is afforded to those that don't need it and don't use it.

Those looking for policies that include dental and prescription reimbursement quickly discover this coverage is even less robust than the medical coverage. As far as the company is concerned, a claim to have a cavity fixed is the same as a claim for a hospital stay. All claims have some sort of cumulative effect and more than the occasional claim can have a major impact on future costs and coverage. This is the nature of gringo medical insurance here as it exists today.
 

dulce

Silver
Jan 1, 2002
2,524
211
63
Check to see if this is now applicable to your situation;

https://www.ssa.gov/planners/retire/claiming.html

Tough decisions for those from the US considering retirement in the DR. Especially those who are cash strapped to pay for insurance.

While I am sure that good care exists in the DR, I am not sure all those DR plans cover it (good care, i.e., top hospitals/top doctors). My own private carrier in the US covers me while in the DR, but medicare will not.

I also have health insurance in the DR courtesy of my wife.....so I have multiple bases covered......if needed.


Respectfully,
Playacaribe2

Helpful info in the link. Thanks again.
 

Derfish

Gold
Jan 7, 2016
4,441
2
0
Thank you for the link. Marketing literature is good, but I will check with a broker I know to see if Universal is the ONLY ARS in the DR that allows you to renew no matter what your age.

I think most anybody would have enuff sense to renew if they had it when they got to that age, and i fully understand an insurance company's reluctance to write us up also, Just wish there were such a thing.
 

malko

Campesino !! :)
Jan 12, 2013
5,561
1,345
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Some dr medical insurances allow an "insured"  to add on a family member to the contract, for little or no fee.

MIL was having trouble finding her first-ever medical insurance ( over 60 and diabetic ) . In the end one of her sons, who was covered through his job in a AI had her put on his contract.


P.S.  100$ a month ???? You get nothing for less than around 400 in switzerland ( for an able-bodied working person ) and its obligatory !!!!!!
 

sanpedrogringo

I love infractions!
Sep 2, 2011
2,911
0
0
Coming here for geriatric care is a rapid death sentence.

I really can't bring myself to 'like' the statement, but I do find myself in agreement with you. I would not recommend it to a family member or friend. There's a reason Dominicans with means leave the country to receive treatment.
 

sanpedrogringo

I love infractions!
Sep 2, 2011
2,911
0
0
Same here. Even if nothing wrong, I'll still schedule a check up just to make sure there is nothing brewing. New York is only 3 1/2 hours away.
 

dulce

Silver
Jan 1, 2002
2,524
211
63
Not to misrepresent what I mean. Of course I pay the part B price, but I pay nothing for the supplemental insurance that means all my medical needs are completely covered.

You have no co-pays at all? Doctor visits, prescriptions? Nothing? 
 

SKY

Gold
Apr 11, 2004
13,509
3,637
113
You have no co-pays at all? Doctor visits, prescriptions? Nothing? 



Correct. No co pays. I assume there is some kind of limit for prescriptions, but I have never paid yet for drugs.

You have to understand the system. My address is Dade County Florida. My friend has the same company (United Health Care). He lives in Palm Beach. He pays a $40 co pay for specialists. I do not. Also with my coverage I do not need a referral from my primary doctor. I just make an appointment and go. No cost ever.
 

dulce

Silver
Jan 1, 2002
2,524
211
63
Correct. No co pays. I assume there is some kind of limit for prescriptions, but I have never paid yet for drugs.

You have to understand the system. My address is Dade County Florida. My friend has the same company (United Health Care). He lives in Palm Beach. He pays a $40 co pay for specialists. I do not. Also with my coverage I do not need a referral from my primary doctor. I just make an appointment and go. No cost ever.

You are correct about understanding the system and I do not understand it. I do not doubt what you are saying is true. I simply have not heard of an one else never having to pay co-pays. 
You are very fortunate that United Health Care pays for everything. I am currently working and have them for my insurance through my employer . They do not even pay 100% for routine yearly check up blood tests. I am forced to resubmit bills 4 or 5 times. They claim billing code errors. It takes them over a year to partially pay. I sure hope I don't get stuck with United Health Care for Medicare. They are the biggest health insurance company in the US now. That is due mostly in part to Medicare. ARGH!
Count yourself very fortunate you do not have to pay. 
I hope you are in god health now.
 

windeguy

Platinum
Jul 10, 2004
42,211
5,970
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Never felt better, thanks Dulce. For the record, Preferred Care Partners is my plan. They are owned by United Health Care.

I am sure they have many levels of plan, like most companies. Yours seems to be a premium level plan. Very much unlike what most people have.

They are not very highly rated, but you have been very happy with them. Do you pay for the plan or is it through an employer? How costly is it for you to be in the plan?
 

SKY

Gold
Apr 11, 2004
13,509
3,637
113
They are not very highly rated, but you have been very happy with them. Do you pay for the plan or is it through an employer? How costly is it for you to be in the plan?



I pay nothing. It is a supplement plan for Medicare Part B. I only pay the Part B premium. I believe it is $120. They take it directly from my SS.

See post 55, I posted the link.
 

SKY

Gold
Apr 11, 2004
13,509
3,637
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OK. That is $120 a month, correct?

Yes. Everyone that has Medicare Part B pays for it from their SS. Even if you do not have the supplemental plan you pay the same. The edge is Medicare only pays 80% of cost. With the plan I have they pay for everything.
 

windeguy

Platinum
Jul 10, 2004
42,211
5,970
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Yes. Everyone that has Medicare Part B pays for it from their SS.

Good to know. Not sure it will ever help me since I have no residence in the US, but you never know. I signed up for SS payments this week. My SS payments start in November. Two months after I turn 62. I get an additional month delay because "I started too early"...