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Health Insurance in the Dominican Republic.

The DR is not far behind its better-developed counterparts when it comes to medical care. Foreign medical practitioners have given the country very good ratings in providing care for tourists who have suffered major catastrophic events while on holiday.

In the area of surgery the DR is ahead of many Latin American countries in laparoscopic laser surgery. A good volume of patients come from the Virgin Islands, the Lesser Antilles and other parts of the Caribbean who make the most of the good care and lower fees in this country.

Dental services also offer value for money, with very good treatment and reasonable prices, factors which also attract patients from other countries.

The vast majority of your medical needs can be met on the island. However, interventions requiring high-tech equipment or a long period of rehabilitation may not be available.

It is recommended that you obtain medical insurance as a first priority. Particularly advantageous is a dual policy which covers medical expenses abroad. While investigating different insurance policies, note that in the DR there are very few GPs or family doctors; the vast majority of physicians consider themselves specialists. Therefore, you should choose a pediatrician for your children and an internist for yourself. These doctors will serve as the equivalent of GPs, and they should be able to refer you to other specialists if necessary.

The state healthcare system is free but far from adequate, although it does meet some needs, such as the provision of vaccinations and infant rehydration supplies. Facilities, trained staff and medicines are often lacking. Patients may be asked to pay for materials and for their prescriptions, putting the costs beyond their financial possibilities.

The Social Security system is also far from adequate. Nevertheless, certain Social Security clinics offer good services, and even people who have alternative medical insurance may choose to take advantage of benefits such as the provision of free milk.

Private clinics are also an option in the DR. Fees, however, range from RD$400 to RD$3,000 for a first visit, depending on the clinic and the specialist.

Many employers provide insurance called an “iguala,” which can also be purchased on an individual basis. Monthly payments are made to a certain clinic, which agrees to provide all the medical services that you need at no additional cost. Certain limitations may apply. For instance, it may be possible that a certain type of specialist is not available at your particular clinic and you have to go elsewhere, and you will in effect have no cover under the scheme.

True medical insurance plans come in various types. One type will reimburse your medical expenses, possibly including your medications. This type of plan provides broad coverage, but you need to have the cash to pay your bills at the time services are provided.

A second type of insurance pays a certain portion of each bill. For example, you might be responsible for RD$50-RD$100 of any doctor’s fee of RD$600. This type of plan often has a restricted list of physicians or clinics, and the list will change from time to time.

Foreign insurance companies based here (primarily from the US) offer insurance which includes coverage abroad. The best idea is to purchase a policy with a very high deductible (excess) for overseas care to reduce the cost, as this is essentially only for major disasters.

Many medical insurance policies are available to individuals for virtually the same price as they are offered through employers. The prices of these policies will depend on the age of the applicant, and the company he/she is applying to. The monthly costs can vary, though an individual, however, might have to pay for six months to a year in advance rather than benefiting from a monthly payment schedule.

Two of the largest insurance brokers are Ros & Associates, located on Winston Churchill at the corner of José Brea Peña, Tel. 567-1021 or 562-4556 and Franco-Acra & Associates, Winston Churchill 32, Tel. 535-1655. Other providers include La Colonial, La Monumental, Seguros Banreservas, Caribalico, Seguros World Wide, Proseguros and Seguros Popular.

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