Medical Insurance, Humano ARS

drSix

Silver
Oct 13, 2013
1,323
0
0
I had the Humano Max Plan for just under a year. It cost me $450 every three months for four people. I called them and said that I needed to remove my son from the plan, as he was moving back to the US, and add myself as I was no longer covered by my employer.

In order to do this, I had to cancel my old plan and start a new one. When I first signed up, I signed up through a Spanish speaking agent, over email, using Google translate. I didn't really ask a lot of questions, stupid me. This time I signed up with an English speaking agent, so I was able to ask more questions. Things I sadly did not know the first time around is that you have to wait a YEAR before they will cover anything "catastrophic". Emergencies are covered right away, but just the ER bill and consultation. After 3 months they'll pay for one nights hospital stay, after six months a little more.

Regrettably, I have experienced the DR healthcare system, before I had insurance, and was paying cash. The ER bill and consultation, the only things that would have been covered, were peanuts compared to the surgeons, surgery, and hospital stay bill. Even if I had insurance, I still would have been footing most of the bill.

To clarify, I asked, because "emergencies" are covered right away, what would be covered if I had a heart attack.

The ambulance bill, the emergency room bill, and the consultation with a cardiologist. Basically, the doctor who is going to say "yup, yer having a heart attack, yer gonna die"! What wouldn't be covered is the cath lab, surgery, hospital stay ect. because it is considered a catastrophic event. The same scenario if I had a broken leg. Only the ER visit and diagnosis from an orthopedic surgeon would be covered until you hit the 1 year mark of continuous coverage.

Office visits, cough and colds, check ups are all covered. But you cares, that stuff is dirt cheap anyways.

So, buyer be ware. I now have travel insurance. We're all covered, right now, for up to US$50,000 and it costs me $295 every three months. And that even includes evac back to the states. The agent also told me that the local hospitals love to see that insurance cause they know they can charge Gringo prices.
 

charlise

Bronze
Nov 1, 2012
751
0
0
If I understand your post correctly, which I'm not sure I do, you did not sign for a Dominican insurance but bought a travel insurance from a US company ??
 

drSix

Silver
Oct 13, 2013
1,323
0
0
If I understand your post correctly, which I'm not sure I do, you did not sign for a Dominican insurance but bought a travel insurance from a US company ??
I HAD Dominican insurance, Humano ARS for just under a year. When I went to change the names on the plan, they told me that my clock would "reset" and I would have to wait a full year before I had catastrophic coverage. I was unaware of the year wait the first time, so I canceled my Humano and went with a travel insurance plan.
 

MikeFisher

The Fisherman/Weather Mod
Feb 28, 2006
13,052
1,200
113
Punta Cana/DR
www.mikefisher.fun
Carlisle,
he signed for the basic ARS Humano (Dominican Insurer) Plan for a family of 4, comes on around $35-$40.- per person per month.
and he states, that such insurance plan does not start it's full coverage right away, just with basics like ER and consultation of a doctor, while for the full coverage of that anyways not high covering Max-Plan you have to wait a year to get those benefits.
never paid attention to the Max-Plan, so don't know it in details.
i have for several family members their so named Royal Plan, a decent basic coverage.
the full coverage of that Plan starts at day one of the registration, but that may also be because i have those insurances running under my company, not as private person contracts.
hence i do not need any upfront "deposit" or such nor any prepayment of 3 months at a time,
i can pay monthly and just for that starting month.
the higher the Plan, the higher the coverages of different things of course.
i have also 5 persons covered under the same ARS-Humano in their Platinum Plan.
both types of Plans been used for many different things, including costly surgeries,
to date all been fine with the coverage.
again,
i could not tell about differences between a Plan taken as a private person and the Plans i have as a business.

also he stated that he has in Addition to that local DR insurance,
a US-Travel Insurance, which is very much liked by doctors and hospitals, as they seem to be able to bill higher bills than they could bill to a DR Insurer, for the same procedures/emergencies/surgeries etc.

Mike
 

charlise

Bronze
Nov 1, 2012
751
0
0
That part I understood... Just wanted to make sure I understood the last paragraph... So that's clear. You have a travel insurance that covers you and your family (?) for mas o menos 100 $ per month, for the whole family ?...

Are you covered all year long ? Here ? And it's accepted in clinica and centro medico without problem ? If so, that's interesting.
 

MikeFisher

The Fisherman/Weather Mod
Feb 28, 2006
13,052
1,200
113
Punta Cana/DR
www.mikefisher.fun
I HAD Dominican insurance, Humano ARS for just under a year. When I went to change the names on the plan, they told me that my clock would "reset" and I would have to wait a full year before I had catastrophic coverage. I was unaware of the year wait the first time, so I canceled my Humano and went with a travel insurance plan.
sorry, posted before i could see your answer

Mike
 

drSix

Silver
Oct 13, 2013
1,323
0
0
That part I understood... Just wanted to make sure I understood the last paragraph... So that's clear. You have a travel insurance that covers you and your family (?) for mas o menos 100 $ per month, for the whole family ?...

Are you covered all year long ? Here ? And it's accepted in clinica and centro medico without problem ? If so, that's interesting.
Correct. I pay less for the Travel Insurance than I did the Humano, and I am covered for ANYTHING, right away. From travelers diarrhea to drunken moto accident. I specifically asked if it would be accepted at CMC(Not that I would ever go there again), and he said "Yes, they love seeing that card because they can charge Gringo prices" It is a three month policy for the whole family, with evac insurance, and I can renew it every three month for up to two years.
 

drSix

Silver
Oct 13, 2013
1,323
0
0
The US State Department has a list of Travel Insurance Providers, found here.

I signed up for International Medical Group, which isn't on that list.

International SOS is on that list, and as I have previously done contract work for them, I can attest to their awesomeness. They are little expensive, but you get what you pay for.
 

william webster

Platinum
Jan 16, 2009
24,246
949
113
I have posted that name here before... excellent company.
Affiliated with Lloyd's of London, I think.

My coverage is RD, Canada & USA
 

amp

Bronze
Oct 5, 2010
730
8
18
I was upset when my wife got them as well but it seems that it's like that with every insurance company here.

Lots of stuff isn't covered until 3, 6, 9, or 12 months into the plan.
 

franco1111

Bronze
May 29, 2013
1,029
93
48
Gringo
I had the Humano Max Plan for just under a year. It cost me $450 every three months for four people. I called them and said that I needed to remove my son from the plan, as he was moving back to the US, and add myself as I was no longer covered by my employer.

In order to do this, I had to cancel my old plan and start a new one. When I first signed up, I signed up through a Spanish speaking agent, over email, using Google translate. I didn't really ask a lot of questions, stupid me. This time I signed up with an English speaking agent, so I was able to ask more questions. Things I sadly did not know the first time around is that you have to wait a YEAR before they will cover anything "catastrophic". Emergencies are covered right away, but just the ER bill and consultation. After 3 months they'll pay for one nights hospital stay, after six months a little more.

Regrettably, I have experienced the DR healthcare system, before I had insurance, and was paying cash. The ER bill and consultation, the only things that would have been covered, were peanuts compared to the surgeons, surgery, and hospital stay bill. Even if I had insurance, I still would have been footing most of the bill.

To clarify, I asked, because "emergencies" are covered right away, what would be covered if I had a heart attack.

The ambulance bill, the emergency room bill, and the consultation with a cardiologist. Basically, the doctor who is going to say "yup, yer having a heart attack, yer gonna die"! What wouldn't be covered is the cath lab, surgery, hospital stay ect. because it is considered a catastrophic event. The same scenario if I had a broken leg. Only the ER visit and diagnosis from an orthopedic surgeon would be covered until you hit the 1 year mark of continuous coverage.

Office visits, cough and colds, check ups are all covered. But you cares, that stuff is dirt cheap anyways.

So, buyer be ware. I now have travel insurance. We're all covered, right now, for up to US$50,000 and it costs me $295 every three months. And that even includes evac back to the states. The agent also told me that the local hospitals love to see that insurance cause they know they can charge Gringo prices.
When I see this is "travel insurance" I wonder how long you can out of the country before they drop the coverage. What I have now ends at 90 days. This is ok for me because we go back to the U.S. more frequently and so I am a traveler : ) Do you see how long you can be out of the country with your policy? Maybe no issue, just wondering...
 

drSix

Silver
Oct 13, 2013
1,323
0
0
When I see this is "travel insurance" I wonder how long you can out of the country before they drop the coverage. What I have now ends at 90 days. This is ok for me because we go back to the U.S. more frequently and so I am a traveler : ) Do you see how long you can be out of the country with your policy? Maybe no issue, just wondering...
It says I can renew the policy every 90 days for up to two years. So, once you hit the two year mark of coverage you're done. But, I don't see that as a problem as their are dozens of companies out there offering travel insurance. After two years, you just go with another company.
 

Cdn_Gringo

Gold
Apr 29, 2014
7,555
425
83
Be careful with travel insurance. I can't speak for every company out there, but the ones I have dealt with in the past all used post-claim underwriting.

This essentially means, the company is very happy to take your premiums, promise you a world of service, but coverage doesn't actually kick in until you file a claim. It is at this time that the search begins for a reason to issue a denial. Some reasons I have heard of include the all important "preexisting medical condition" as discovered when they review your medical records from your doctor at home, an incorrect answer entered on the initial paperwork/online application, not meeting the company's definition of a traveler etc.

It is prudent to speak directly with your travel insurance provider and specifically ask when coverage is guaranteed/approved using the specific term "post-claim underwriting". Of course ask for any answer to be sent to you in writing. There are many examples of these companies denying claims for spurious reasons. In one case, the question on the application asked if the insured had ever had tests relating to a heart condition. The applicant answered NO but there were numerous blood pressure monitoring results scattered throughout their medical file and thus the insurer denied a claim based on an incorrect answer on the application.

It sounds stupid and probably is, but the focus of many of these travel insurance companies is collecting premiums and only paying claims when they can find no reasons (however small and stupid) not to.

It has been reported that even your family doctor may not be able to fill out the required forms in such a way as to prevent a denial of claim. The average layperson doesn't have a chance.

http://www.cbc.ca/news/business/how-to-navigate-the-risky-world-of-travel-insurance-1.2840955
 
Last edited:

MikeFisher

The Fisherman/Weather Mod
Feb 28, 2006
13,052
1,200
113
Punta Cana/DR
www.mikefisher.fun
Be careful with travel insurance. I can't speak for every company out there, but the ones I have dealt with in the past all used post-claim underwriting.

This essentially means, the company is very happy to take your premiums, promise you a world of service, but coverage doesn't actually kick in until you file a claim. It is at this time that the search begins for a reason to issue a denial. Some reasons I have heard of include the all important "preexisting medical condition" as discovered when they review your medical records from your doctor at home, an incorrect answer entered on the initial paperwork/online application, not meeting the company's definition of a traveler etc.

It is prudent to speak directly with your travel insurance provider and specifically ask when coverage is guaranteed/approved using the specific term "post-claim underwriting". Of course ask for any answer to be sent to you in writing. There are many examples of these companies denying claims for spurious reasons. In one case, the question on the application asked if the insured had ever had tests relating to a heart condition. The applicant answered NO but there were numerous blood pressure monitoring results scattered throughout their medical file and thus the insurer denied a claim based on an incorrect answer on the application.

It sounds stupid and probably is, but the focus of many of these travel insurance companies is collecting premiums and only paying claims when they can find no reasons (however small and stupid) not to.

It has been reported that even your family doctor may not be able to fill out the required forms in such a way as to prevent a denial of claim. The average layperson doesn't have a chance.

http://www.cbc.ca/news/business/how-to-navigate-the-risky-world-of-travel-insurance-1.2840955
a important point on that is
the insurer's definition of a TRAVELER,
as they do not have to pay a thing for someone who LIVE'S out of country.
for example a wife and kids, living/beeing raised in the foreign country,
is for a Travel Insurer never a Traveler, just a resident, and as a Resident you need the local insurances of your new country of choice, as they do not see you as a Traveler then.
Insurers are anyways around the globe fraudsters,
for the simplest thing you get the link to a ten thousand pages of fineprint,
which even the brightest studied minds disagree about each's "understanding/interpretions" about,
let alone us average folks.

Mike
 

SKY

Gold
Apr 11, 2004
9,959
269
83
The biggest crooks on earth today are Insurance Companies. They have a team of lawyers to figure out how NOT to pay claims.
 

william webster

Platinum
Jan 16, 2009
24,246
949
113
Be careful not to confuse Int'l Medical Group with the classic definition of 'Travel Insurance'.

Standard travel insurance covers your flight & trip.
This type of insurance is for people who intend to travel, live elsewhere for extended periods.

For instance, I am covered in RD, Canada & USA but it is stipulated in my policy that I may not spend more than 6 months in the USA.

IMG serves those who go on sabbaticals for a year or more, those with foreign postings.

I can vouch that they cover all medical expenses.
You choose your desired deductible and the policy price is derived from that.

They have a concierge service.
Call up with your problem and thye will direct you to a doctor - price prenegotiated.

My wife had a mammogram in the US. They wanted about $1,000US.
IMG called and restructured that price to less than $400...... no fuss from us.

Yes, we have evacuation coverage.... prescriptions, etc

Again, not to be confused with what an airline sells you for a vacation - more permanent... long term.
 

Cdn_Gringo

Gold
Apr 29, 2014
7,555
425
83
True, there is definitely a distinction between vacation travel insurance and longer term plans offered by major insurance companies for those who will be residing outside their home country for extended periods of time. Sometimes, having residency outside your native country is enough to cancel a policy, not always. The details in the "fine print" are important.

As a general rule, if you do not have to submit to a medical exam or forward your health file to an insurer when you purchase a policy, you are subject to post claim underwriting and this very fact could mean that your first claim can and probably will be denied if a reason to do so can be found.
 

william webster

Platinum
Jan 16, 2009
24,246
949
113
If you are correct - yes, we submitted our medical files upon application.

My understanding is that our policy is specifically for those residing outside their prior jurisdiction.....
hence the US visit restriction on the policy.

I left Canada in 1995.......... left the US in 2009
 

silverjane

Newbie
Oct 20, 2018
3
0
1
No sorry .I live in Canada now. Retired so I am applying for resident visa as husband is Dominican and we will spend more time there in next few years. I have extended health care package here that is very good for 93 day stay out of country. I think that the Visa office will ask for proof of health insurance and not sure if they will accept my policy. Should I get additional coverage? I likely will not stay more than the 93 days during each visit.
 

william webster

Platinum
Jan 16, 2009
24,246
949
113
You will not be asked for health coverage...
I have never been asked for it ... since 2008

if you wish - you can buy DR insurance..