Well! My daughter's broken leg cost us about $6k. $1,500 at CMC in Sosua just for them to make it worse, and another $4,500 at HOMS in Santiago for the same, but better, care. At CMC, they would not even look at us without $500 down, and they won't discharge you until full payment is made. At HOMS we had to pay $3k upfront, because a toddler with a broken leg isn't am emergency. We didn't have insurance, but now we do. I'm not sure that it would make much of a difference though. Now I have Humano ARS with 80% coverage for $150 a month for four people. Whether or not it will actually pay, I don't know. An injured gringo is a big cash cow for a Dominican doctor. Cash will get you seen and treated, that I know. So, get insurance, have $1k in cash in an envelope, and a credit card with at least a $5k balance to cover all the bases.