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health insurance

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Sclinton
  4/13/2014 16:41 EST

I am planning on living in the DR for at least 6 month and if I like it for years. Is it possible to buy health insurance as a non-resident?

Sereno
  4/14/2014 06:40 EST

Sorry that I can not answer you question regarding having to be a resident to obtain health insurance here. I'm told that the price is very reasonable and most private clinics/hospitals except it. It is only good in the D.R.

Many major health insurance companies in the U.S., and other countries, have an option for Ex-pats.

Ours was about half the cost and we have emergency medical evacuation. It covers us anywhere in the World. (My wife travels a lot and all over the World.)

I've had a couple of minor surgeries done here at a fraction of the cost that would be charged in the U.S.

However, if we should have anything major, we would go back to the States as others that have done going back to their own Countries for major health problems.

I hope others can better answer your question.

;) Sereno

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Planner
  4/14/2014 10:48 EST

Yes you can get insurance here without having residency! I currently run a small group package using one of the 2 main suppliers. It is not expensive but you must apply before age 65.

My package offers prescription coverage (to a limit) and dental in addition to the health care plan.

If you want to contact me, send a private message and I will respond to you.

My two plans are currently about US 35 or US 47 per month per person.

randylewiskemp
  4/14/2014 16:30 EST

I came across an interesting site that brokers expatriate health insurance polices. And no - I get no fees or money for mentioning them. They are brokerfish dot com and I found them via a travel article.

Sereno
  4/14/2014 17:07 EST

Hi Randy! Imho?

I take people at their word and consider all leads/information/experiences to be of help and value with so many having different experiences. We are in an on going learning experience that is constantly changing.

Unless/until the spam gets to be too much. :(

This site has an ad for Cigna. It just below the posts. I have not looked at them since I don't need nor wish to change at this time.

Perhaps the OP can inform us regarding what he/she finds that would be a help to all.

Did you know? As an Ex-pat resident here in the D.R., getting a little older, we can NOT get the Dominican Health plan at age 65 even if we want it. Our U.S. Medical provider is also upping our fees........ as we are getting.... a little older.

Thanks. Sereno

Planner
  4/14/2014 17:41 EST

yes you can buy insurance using a copy of your passport, you do not need to be a resident.

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Planner
  4/14/2014 17:43 EST

Shows the importance of getting insurance while you are both young enough and healthy enough!

I was an insurance professional before moving here and it is a pretty different world here that is for sure.

Sereno
  4/14/2014 19:04 EST

Thanks Planner.

We have paid our U.S. medical and life policies for over 30 years. They both have decided that 65 is a BIG game changer. We feel more then a little "taken" as we approach that magic age.

It is VERY different here. Any words or wisdom?

thanks, Sereno

Ltindal
  4/14/2014 20:01 EST

Sereno, If you are a resident of Miami or S. Florida, you can purchase a plan named Dominican Health Care. It's a medicare advantage plan. You will have coverage in STD, at Cedimat Hospital and at Humana Hospital's in Florida. I purchased it in 2012 at the Dominican Consulate in Miami, when I moved to DR. At the time, I also had Blue Cross & Blue Shield plus Medicare A&B. Things were good until I had to go to the DR hospital. That nightmare was to long to share; unknown to me was the fact that I would lose both BC&BS + Medicare by buying the DR plan. This information, like most information given to gringo's in DR, was only about a third of the amount of info that should have been given to me by the insurance rep at the DR Consulate. I discovered this after I attempted to make a doctors appt. in USA, so I dropped the Dominican plan like third period French. Yes anyone can buy a DR plan, but trusting your life in the hands of a DR hospital is very dangerous.

Planner
  4/15/2014 10:17 EST

Sereno

Unfortunately there is all too often small print in these policies.

I would not live here without LOCAL insurance. It is decent coverage at a reasonable price and gets you in and out of most major clinics without too much fuss! It isn't meant for those catastrophic cases like quadruple bypass for expats who may want to have it done at "home". It is meant for daily medical needs, accidents (broken ankles - I've had two) illnesses that crop up here etc.

I have been lucky to have good health care here both on the north coast and in the capital city.

Planner
  4/15/2014 10:19 EST

I don't know much about that "plan" but i will disagree on the health care here. Some of it is excellent! You do need to do your homework for clinics and doctors and take your own health care seriously! I always do my own research and often get a second opinion!

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randylewiskemp
  4/15/2014 12:45 EST

I'm a bit confused why you would lose Medicare, if you bought another plan. From my understanding, Medicare only covers US treatment only. You need either the public or private insurance plans, if you reside in another country. How do they come into conflict?

Sereno
  4/16/2014 07:12 EST

Lot's of good information people. Thanks.

As we approach that magic age of 65 we have a lot to consider and will have to look at our options in the near future.

Randy does ask a good question regarding Medicare in the U.S. having been compromised by a plan in the D.R. ??

I hope that the OP gets back to us with his/her input.

Let's have a healthy day! Sereno

Planner
  4/16/2014 09:14 EST

That just doesn't make much sense to me! It should have NO bearing on your insurance there. But hopefully he will fill us in.

Ltindal
  4/16/2014 10:38 EST

Bom dia Sereno; I've been with Medicare for 9 years now. Medicare have a thick book of recipient benefits, rules and regulations that its members can request annually. I my case, as in anyone else who select a Medicare advantage plan, and have an current secondary health plan (Blue Cross/Blue Shield), Medicare will not cover your medical expense's. I had to learn this the hard way, through experience. I had a kidney transplant and have to take many drugs daily to stay alive. I've had two doctors in DR tell me not to trust the medicine here. For me, unlike others who just want DR hospital's to fix a broken bone or Flu, or feel that they are invincible, it's a matter of life and death. Therefore, I return to the states every 90 days to get my meds and get a check-up. I can only speak of my experience, and as a retired person with executive level experience from the USA, I have a history of FAQ checking, only to discover that I was mis-lead at the DR Consulate in Miami where I signed up

for the DR Healthcare Plan. To the others who are seeking answers to the healthcare issue, I suggest that you do as Sereno and I have done. Just move here and learn as you go. Good Luck.

Planner
  4/16/2014 11:14 EST

Yes I can understand completely why you will fly home for this!!!!

Sounds like this DR healthplan is not what we use here on the island for our regular monthly pay plan.

Thanks for the additional information!

Ltindal
  4/16/2014 14:24 EST

To Planner; Exactly! I dropped the Dominican Plan, and re-activated my Medicare and my Blue Cross/Blue Shield plans. I can if I choose, go and get serviced at a DR hospital and pay cash. Afterwards, I could submit the charges to BC/BS for re-imbursement. Trust me, it's not about the money, it's the service, and quality care, and the meds.

boater
  4/16/2014 14:54 EST

Just want to get this clear. I know that Medicare will not cover any care received outside the United States. Supplemental insurance, either a retiree plan or a Medicare Advantage plan may cover medical expenses outside the US, but you have to pay cash and then seek reimbursement. I don't know what this "Dominican Plan" is, but I believe having insurance in the Dominican Republic (from a Dominican company) will cover medical expenses in the DR without affecting Medicare eligibility in the US as long as you keep paying the Medicare A & B deductions each month. The sticky point is that all or most Dominican medical insurance companies will not cover you in you apply for insurance after you turn 65. Also, the DR companies require a medical exam and may not cover pre-existing conditions. I personally am keeping up my Medicare payments and also pay for medical evacuation service that will transfer me back to the US if necessary. That medical evacuation service is expensive (more than $1,000 a year) but seems worth it so that I can access Medicare in case of a serious problem. There is no perfect solution, especially for older people, but it is worth noting that good medical care, such as at HOMS in Santiago, is much cheaper than in the US. And they will usually take US credit cards. If there is something I've missed or misunderstood, please let me know. Thanks.

Sereno
  4/16/2014 17:03 EST

Thank you boater.

I was coming to your conclusion that you stated rather well.

In a few years my wife and I will have to make that change from what is now a good plan but will go so expensive that we will have to look new policies.

Since I don't travel much, I can get the U.S. Medicare with the emergency evac just in case of something really major. I'll have the D.R. plan for everything else.

Our current plan needs pre-approval down here and then they pay us. Cataracts done here didn't get near my deductible so all out of pocket anyway. (under $5K vs over $20K going back to the States and having to rent place/car/live for a couple months.) IF I had the D.R. insurance as well, they would have kicked in for some of that under $5K.

As others have pointed out, the D.R. does have some good medical facilities and people but .... not for open heart work, aggressive cancers and kidney transplants.

If I travel to other countries other then the D.R. and U.S., then other policies can be purchased.

My wife however, will cost an arm and a leg staying with our present provider since she travels the World and needs that coverage.

Well done guys and thanks.

Bottom line to the OP. You can get medical insurance here in the Dominican Republic using your Passport. Right?

Sereno

Planner
  4/16/2014 18:42 EST

You must apply before age 65. Sometimes they require a physical and sometimes they do not. Not all my clients have had to get them.

Some pre existing conditions will be excluded.

But you can get coverage for everything else! yay....

StevenBarr
  5/1/2014 09:56 EST

Yes I bought health insurance at age 58. I have used it very little for me but the wife takes the kids all the time. My little one broke her leg she was taken to HOMS in Santiago.

Dr. Cruz spoke english and was a fine dr. I woked in the emergency medical field in Miami for 30 some years, I think (my wife pays) we pay around 120 dollars a month. Humano royal plan 809 4763535 or 809 200-4903 is the Insurance company

steve in dr

Planner
  5/1/2014 10:08 EST

Good info. Humano is the company I use for my group and I am very happy with them.

Kiskeyanos
  5/6/2014 23:53 EST

I120 dollars?? s this for you, the wife and the kids...or just you?

Sereno
  5/7/2014 07:11 EST

Nice to see you again Kiskeyanos. I hope that your research is going well.

We bought a med. insurance for our main worker a couple of years ago. He was single, good health and 22 years old.

12,000 DP per year = U.S. $277.52 py.

Dominicans are covered by a National Insurance but they are limited to the Dominican clinics and those don't provide the best of care.

Our other worker was in a moto accident several years ago and the National plan installed steel rods in his legs.

Fast forward: One of the rods pins had broken and the rod moving around and was sticking out of his leg and very infected; after I had noticed him limping and his pant leg wet. He told me the story and that the National plan would do nothing except cut his leg off.

I had him at our upscale clinic within 15 minutes. They do not take the National Insurance. They operated the next day. Another week and they would have taken his leg the infection was so bad.

No insurance. We paid for the surgery and private room (U.S. $1,619) plus food and lodging for some of his friends and family for 3 or 4 days and full pay while he was off recuperating for a month.

No, we are not bleeding hearts nor need any pats on the back.

He still works for us; a good worker and a nice young man. The price to save his leg was so small.

I would hate to think what this would have cost in the States.

I'm hope others can better answer your question but some phone numbers have been provided so you can get some real quotes.

: ) Sereno

Sereno
  5/7/2014 08:43 EST

A few more examples.

10 years ago I had a hernia operation at one of the better clinics/hospital in Santiago.

One day spent consulting with 3 different doctors and having tests done to confirm the hernia. Spent the night at a hotel.

Operation the NEXT morning. Private room for the night and checked out.

U.S. $700. that included everything at the hospital. We paid cash and submitted to our U.S. expat insurance. They called us saying that the decimal was in the wrong place and another 0 was needed. We are just to dang honest. Our deductible is U.S. $5,000 per year.

Cataract operations on both eyes last year in Santo Domingo. Done 1 week apart. Everything included was U.S. $4,500. Again, didn't make the deductible.

We had been in the States and consulting with an eye surgeon and the surgeon in S.D. told me the same thing.

U.S. $ minimum would have been over 10K, plus travel, apt. renting, car rental and misc. They wait 1 month or was it 3 months between eyes. We figured it would have been over $17,000 doing it in the States, our insurance would not pay for the flights, lodging, car or misc.

A close friend of our main man was run over by a car and I never want to see the photos again. Taken to the upscale hospital that does not take the national insurance and they refused him while he is about to bleed to death. He was loading into the back of a truck a taken to another hospital. Major surgery and took off one leg just above the knee. Next day took up to mid thigh. Next day just below the hip.

We donated so that his friends and family could stay with him and do the nursing. We gave our man several days off, he slept on the hard cold floor next to his friend.

Very little care provided after he was discharged. No re-hab at all. Not even a walker, wheelchair or crutches. We again helped out via our man not wanting to be the "big shot" gringos.

We have ordered a prosthetic in the states, at no charge, that we hope will help. What they wanted to charge here was outrageous.

Guy is 20 years old, married, child and has a full time job (we know his boss) and he was back at work within 2 months on walker and crutches.

Sereno

Kiskeyanos
  5/8/2014 16:34 EST

Hola sereno. The above post was not me! But good info on health isurance. I was freaking out because the quotes I saw were over 200 us a month (cigna) so if you are a citizen or a resident you can purchase private insurance at less than 300 dollars a year? This is encouraging. My children have us insurance as an adoption agreement and they could be covered in PR, but not DR and we would not be eligible for our retirement insurance until we reach 62 (we will be around 58 when we retire and move) besides out contribution to the plan would be about 150 dollars each a month and out of us coverage is limited. So my husband and I would need private insurance and maybe medivac insurance for the kids.

bobby7110
  5/8/2014 17:21 EST

Ok, from my experience there are a few insurances available… I chose ‘Constitucion’ because it’s easy – just fill out the form and pay while some others make you jump through hoops, take tests, etc - plus the office was down the block … It costs ‘a little’ more, I chose a small deductible instead of none, and I added on dental and ambulance service… I’m a 58 yo male and I pay $450/year w/ payments due every 3 mos… Insurance works differently here – I still pay for basic services but at a ‘discount’ – “ummm, right”… If I have an accident and am hospitalized they foot the whole bill… Get the insurance ‘now’ because they will not write policies after 60 yo …

Planner
  5/9/2014 11:51 EST

Insurance is readily available here! You must have a passport OR a cedula to apply. You must be below age 65 to apply and coverage continues after age 65.

The two big companies are Humano and Universal, both are good.

I offer a group insurance package to expats and locals to anyone who wants to apply. I offer two plans only one is 1,430 RD (US 33) a month and the other is currently 1,893 RD (US 44) per month, both include dental and prescription coverage.

I find these two companies the best for both coverage acceptance by doctors and clinics and ease of their administrative processes.

If you want more info then message me.

Sereno
  5/9/2014 16:51 EST

Hi Planner.

We have used an agent for several years for auto and misc. The agent says that we CAN get a med. insurance policy in the D.R. when over 65 but it will cost a little more.

Can you look into that and comment please.

(You may get a PM sooner then I expected. dang.)

Thanks. Sereno

Sereno
  5/30/2014 17:31 EST

I read somewhere ??? in the last couple of days that a New Cancer Clinic opened in the D.R. and is said to be the best in the Caribbean with the newest equipment and best staff in Latin America.

I can not find the article nor find it via Google.

This would be a wonderful advance for the D.R. and region if true.

Anyone else see the article and can add some information?

Planner
  5/30/2014 17:54 EST

Dominican today? I also saw something posted on Facebook that came down on my wall. It was from a business page.

Sereno
  5/30/2014 18:05 EST

I don't know where I saw it Planner. But you would be the person in the know.

A game changer for some of us that have put off changing our medical insurance IF the new clinic is as good as I remember reading AND takes the paid medical plans offered here in the D.R.

Planner
  6/2/2014 10:26 EST

I will have to find out about the cancer clinic for you!

Update on my latest use of my insurance.

I broke my left foot in two places: visit to emergency, pain meds, xrays, orthopedic specialist and cast...............cost to me 0. NOT one peso.

Crutches - I can't have a walking cast, they cost 1,100RD and now I own them.

Yayyyy. Cast comes off in 11 more sleeps!

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