Let's talk health insurance!

[LindseyKaufman]

So I am now 70 years old. I am in good health, more or less. I have a great policy with Universal. It paid for a knee replacement, but nothing else over the years.

However, the costs keep rising with my age. I am told since I am in the system they will never kick my out, but am now paying more than $3,000 USD each year.

I do have medicare in the US, but it is the basic plan.

I guess I want to know what other long time ex-pats are doing here, what they are paying, with whom, and how they are handling their health.

 

[SKY]

That is a really high price for the DR. What kind of coverage is that for?.......

 

[bob saunders]

My wife and I have MAPFRE PRESTIGE and pay 13,500 pesos a month which works out to just under 2800 $US per year for the two of us. I am 67 and her 65. So, are you paying for just yourself? I have Blue Cross Canadian Veterans Medical Insurance which is free and covers my pre-existing conditions. I have not used it, so far.

 

[LindseyKaufman]

I have the Exclusive plan with Univeral. It is not their top plan. My last bill was 45,000 RD and I pay it 4 times a year.

Being 70 years old I do not think I can get a different plan. Correct me if I am wrong.

 

[cavok]

I have Universal and pay 3900 pesos/month. I do not have any medication coverage. For me, it just isn't worth it. The premium costs more than the medications I'm taking.

 

[LindseyKaufman]

I have Universal and pay 3900 pesos/month. I do not have any medication coverage. For me, it just isn't worth it. The premium costs more than the medications I'm taking.

Although I have medication coverage I never use it. So I tend to agree with you.

Which plan do you have?

Trouble with health insurance you do not need it until you need it.

 

[El Hijo de Manolo]

My wife and I have MAPFRE PRESTIGE and pay 13,500 pesos a month which works out to just under 2800 $US per year for the two of us. I am 67 and her 65. So, are you paying for just yourself? I have Blue Cross Canadian Veterans Medical Insurance which is free and covers my pre-existing conditions. I have not used it, so far.

67?? Come on Bob, did you misplace a decade somewhere

 

[cavok]

Although I have medication coverage I never use it. So I tend to agree with you.

Which plan do you have?

Trouble with health insurance you do not need it until you need it.

I just looked on my card and it doesn't say(?). I'm sure it's not the premium one you mentioned. I think it's just their basic plan but it has covered a lot of things for me. The only surgery I've had though is an appendectomy

You definitely need health insurance here. You might be able to downgrade your plan, but you almost definitely won't be able to switch companies. I have Medicare in the US to cover any really major surgery or treatment.

 

[LindseyKaufman]

What I wonder is if it would be wiser to upgrade my Medicare plan and downgrade my insurance here.

 

[cavok]

I just looked on my card and it doesn't say(?). I'm sure it's not the premium one you mentioned. I think it's just their basic plan but it has covered a lot of things for me. The only surgery I've had though is an appendectomy

You definitely need health insurance here. You might be able to downgrade your plan, but you almost definitely won't be able to switch companies. I have Medicare in the US to cover any really major surgery or treatment.

I forgot to add I did have cataract surgery here, also - both eyes. $600 total out of pocket with the plan I have.

 

[JD Jones]

So I am now 70 years old. I am in good health, more or less. I have a great policy with Universal. It paid for a knee replacement, but nothing else over the years.

However, the costs keep rising with my age. I am told since I am in the system they will never kick my out, but am now paying more than $3,000 USD each year.

I do have medicare in the US, but it is the basic plan.

I guess I want to know what other long time ex-pats are doing here, what they are paying, with whom, and how they are handling their health.

What a coincidence. I was getting ready to make a post about Universal myself.

Universal insurance used to be one of the best on the island but those days are long gone.

I need to have knee surgery and I can't find an orthopedic surgeon who accepts Universal. (I'm a vet and can go to the Miami VA, but I'm not crazy about that even though it is light years away far better for me and it's free but that's another story)

All because Universal doesn't want to raise their payments to the doctors so they won't accept it. (So far, getting clinics to accept it is not a problem.)


I'm trying to decide if I even want to keep it, mainly because my premium is $1691 pesos a month, waaaaay below what you and the others are paying for yours.

Lindsey, frankly I'm a little surprised to read your questions about alternate insurance because I have been mentioning SENASA ARS here on the board for years! SENASA is the govt. insurance that provides coverage for the majority of Dominicans.

You can get the SENASA ARS plan for a lot less than what you pay now. You may have to get a health checkup, but even if you have something it won't affect your ability to join the plan.

Time to start reading:

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

You can switch the website to English in the upper right corner.

 

[keepcoming]

Wasn't there someone here on DR1 that sold insurance or helped people with plans?

 

[JD Jones]

Wasn't there someone here on DR1 that sold insurance or helped people with plans?

Yeah, but I don't remember who it is. Linds is now in SENASA territory.

Did you look at their website? It's not a bad plan.

 

[keepcoming]

I looked at it. It doesn't seem bad at all. It has a cap limit of $250k (pesos)per case but that still is not bad.

 

[Gadfly]

What I wonder is if it would be wiser to upgrade my Medicare plan and downgrade my insurance here.

Medicare is not covered abroad (except certain rare situations). I have humano plan Royal here around $60 usd/m. It has gone up ~9%/yr last 4 years (“bc Inflation”) I have had 5000 pesos/yr for meds included in premium, need more coverage now, they can adjust higher per their math. At age 70 yrs premium will DOUBLE, so I bought a pasola… ya y ya. It’s a good plan, I’m satisfied.

 

[cavok]

I need to have knee surgery and I can't find an orthopedic surgeon who accepts Universal. (I'm a vet and can go to the Miami VA, but I'm not crazy about that even though it is light years away far better for me and it's free but that's another story)

What's so special about knee surgery that they won't cover it? Artificial knee?

I'm trying to decide if I even want to keep it, mainly because my premium is $1691 pesos a month, waaaaay below what you and the others are paying for yours.

I think the premium is dependent on age(?). Once you 65, or definitely 70, it will go up a lot.

You can get the SENASA ARS plan for a lot less than what you pay now. You may have to get a health checkup, but even if you have something it won't affect your ability to join the plan.

I didn't see on the site how much a Senasa plan would cost?

 

[cavok]

Wasn't there someone here on DR1 that sold insurance or helped people with plans?

I think you're referring to "DRperson(?).

 

[LindseyKaufman]

What a coincidence. I was getting ready to make a post about Universal myself.

Universal insurance used to be one of the best on the island but those days are long gone.

I need to have knee surgery and I can't find an orthopedic surgeon who accepts Universal. (I'm a vet and can go to the Miami VA, but I'm not crazy about that even though it is light years away far better for me and it's free but that's another story)

All because Universal doesn't want to raise their payments to the doctors so they won't accept it. (So far, getting clinics to accept it is not a problem.)


I'm trying to decide if I even want to keep it, mainly because my premium is $1691 pesos a month, waaaaay below what you and the others are paying for yours.

Lindsey, frankly I'm a little surprised to read your questions about alternate insurance because I have been mentioning SENASA ARS here on the board for years! SENASA is the govt. insurance that provides coverage for the majority of Dominicans.

You can get the SENASA ARS plan for a lot less than what you pay now. You may have to get a health checkup, but even if you have something it won't affect your ability to join the plan.

Time to start reading:

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

You can switch the website to English in the upper right corner.

JD, I have been thinking about Senasa ever since Bill Webster (forget what he went by here...WW?) mentioned it. Thanks for the push. Think I will go Monday, since school is cancelled, and inquire about it. I don't mind having an exam. I am old but not yet worn out.

 

[LindseyKaufman]

I'll report back regarding what they tell me.

 

[aarhus]

JD, I have been thinking about Senasa ever since Bill Webster (forget what he went by here...WW?) mentioned it. Thanks for the push. Think I will go Monday, since school is cancelled, and inquire about it. I don't mind having an exam. I am old but not yet worn out.

Isn’t Senasa only for Dom citizens?