- Thread starter LindseyKaufman
- Start date
Let's talk health insurance!
I paid $1200 per eye out of pocket in the US - no insurance applied
my dominican wife (the boss) and I are agents for humano, mapfre ,senasa .
from our experience humano is the best(we are the number 1 seller on the north coast for the past 3 years and number 2 in the country).
Humano is easier to deal with on our end in regard to administration.
They pay claims well and actually answer questions.
People can get Senasa however our concern is that the limit they pay is only 250,000 pesos, the same as a cheaper plan with humano or mapfre.
People can get humano under 65 years and mapfre under 70 years old.
After 70 years old the premiums double.
Insurance is important as you can get admitted and treated in a hospital right away.With no insurance you need to come up with big cash upfront and on an ongoing basis. Prices are regulated with insurance. Without insurance it is the wild wild west.
Insurance is really great for off setting the costs of lab tests.You might pay 200 pesos for maybe 8000-12,000 in tests.
It does save some money on doctors visits.
After 6 months you qualify to get expensive tests like mri, which can be expensive like 25,000 pesos.
You may need prior authorization for surgury, and some tests and other things.
You need a doctor's prescription for this. This can be done in the insurance companies office or from us for example (we send the papers online).
Note. We do have exclusive special rates\plans for veteransand first responders from the USA Canada, Europe and all NATO allied countries, in association with the American Legion who have spent over 2 years putting this together with us. I have been personally humbled by the dedication and work they have done on this.
I hope this is helpful.
yes Senasa has 2 different plans which makes it a little confusing. Larimar for everyone and another one for workers only with a cedula .
It is true, I look a decade younger than I am.
I am not a "worker" nor is my wife , but we have Senasa which is not Larimar. So dont forget the basic coverage for all Dominicans. And yes, you must be a citizen for that. That basic plan does cover some things our Humano plan does not cover.
We have Plan Royal with Humano which will go up as we get older. Someone 70 years old, as we know, will have limited options in changing plans with regular insurers.
I have Medicare Advantage in the USA. If you did not enroll in such a plan at age 65, there will be a penalty which increases the monthly coast for such a plan over the now about $180 US a month basic cost for it.
Lindsey, keep in mind all Medicare Advantage plans are regional and there are various options at different cost levels and widely different benefits. Your cost will be higher since you did not take the option to enroll at 65.
And of course the situation where you have to make it back to the USA to be treated. Please don't believe anyone that says Medicare will cover you in the DR for anything but possible emergency service. Each plan is different so read carefully if you go that route.
And of course the situation where you have to make it back to the USA to be treated. Please don't believe anyone that says Medicare will cover you in the DR for anything but possible emergency service. Each plan is different so read carefully if you go that route.
DRpeson, which of your companies offer these special rates/plans? I'm retired US Air Force, age 61 this October. If you prefer, you can send me a message with info or questions
I just hit 70.I checked a few months back and found out that I was registered with SENASA. I know that during covid the government added about 2 million folks into the government plan. I was one of them. For the last 3 years or so I have Mapfre executive. Its pretty comprehensive. I started paying 3500 pesos per month. Then it went up 4400 pesos. Then when I hit 70 my new fee is 8800 pesos! Well I'm jumping ship with that plan and in the mean time stick with SENASA which is a decent plan. I will look into the SENASA Larimar which cost about 3500 pesos per month and has elevated coverage. I compare SENASA with Medicaid in the US that covers pretty much everything with minimal out of pocket expenses.
You got a real deal. Cataract surgery with intraocular lens implants usually run $3000 to $5000 per eye depending on the type of lens implant.
we have this veterans plan exclusively. dont hesitate to contact me. It will save you a decent amount of money.
I was going to go to Moca to get more infor on Senasa. Where are you located on the North Coast?
The doctors do not accept ARS Universal at all. Nothing to do with my knee. Many doctors in Clinica Abreu are the same.
I'm 72 and my premium before was around 800 pesos a month, so it doubled at 70.
I don't remember how much the SENASA Larimar plan, But the number 2000 pesos a month rings a bell.