How does healthcare work in the Dominican Republic, and what travel insurance, health insurance or expat insurance do you need?

How does the healthcare system work in the Dominican Republic?

What is the quality of healthcare in the Dominican Republic?

• The quality of healthcare in the Dominican Republic varies. Healthcare consists of both private and public options, with private healthcare facilities generally being much better.
• Spanish is the main language spoken, so it can be useful to know some Spanish!
• There are more medical facilities in the cities, especially Santiago and Domingo, than in the countryside.
• Beware! Healthcare fraud (such as overcharging or unnecessary hospitalization) is common in the Dominican Republic, especially with doctors who are contracted by tourist resorts.
• There are many pharmacies throughout the Dominican Republic. They are often open until late and the staff usually speaks English.
• The medical emergency number is 911, but it is often faster to take a taxi. In hospitals, emergency departments are usually called "Emergencia".

How does the public healthcare system work in the Dominican Republic?

• The public health system is run by the Ministerio de Salud Pública y Asistencia Social (MISPAS).
• Due to underfunding, the quality of public health care in the Dominican Republic is not great. Medical equipment leaves much to be desired and there is not always enough staff.
• The health care system is divided into three socio-economic categories: free care for the poorest, employees and business people pay a contribution to the public health insurance and a kind of hybrid version for freelancers.
• There is a public hospital in every larger city. You often have to bring your own things (such as bedding) and it is expected that friends and family will provide your meals, etc.
• There are also public clinics everywhere.
• Health care is partly free when it comes to basic care, but for treatments such as x-rays and medicines the costs can be high.
• Care that is (partly) reimbursed is primary care in clinics, care in hospitals, pregnancy care, vaccinations, HIV/AIDS treatments and some emergency care.
• The government health insurance system is called Seguro Nacional de Salud (SENASA). To participate, you must have a Dominican ID card (cédula) and register with SENASA.
• Public care is cheap, but the waiting times are incredibly long and the care is not designed for complicated treatments.

How does the private healthcare system work in the Dominican Republic?

• Private care, like in many other countries, is of better quality than public care. The knowledge is more up-to-date, as is the medical equipment.
• Waiting times are also much shorter than in public care.
• There are good private hospitals in Santo Domingo and Santiago.
• But… care is not cheap. Good insurance is therefore important.

How is the general practitioner arranged in the Dominican Republic?

• There are almost no general practitioners in the Dominican Republic. Most people go to an internist. He or she can refer you to a specialist, if necessary.
• Some people choose a specific clinic to receive all their care. It can be useful to ask other expats for their advice on a good clinic.

How is the dentist arranged in the Dominican Republic?

• Basic dental care is available through the public health system, but waiting times can be long.
• Many Dominicans and foreigners living in the Dominican Republic opt for private dental care.
• Private dental care is mainly found in the cities and tourist areas.

How is pregnancy care arranged in the Dominican Republic?

• Obstetric care is free through the public system. However, most women opt for private health care because of the better quality of care and shorter waiting times.
• There are many doctors in the private sector and private care also offers access to doulas, childbirth classes, prenatal yoga, etc.
• It is important to find a doctor who aligns with your needs and is open to your wishes. These can often be found in Santo Domingo, Santiago and Nagua. It is useful to ask other expats about their experiences.
• The vast majority of births take place in the hospital. A small percentage of births (less than 5%) take place in birthing centers or in people's homes.
• Usually, the doctor who is present at the birth is the same doctor who has been with you throughout your pregnancy.
• There are midwives in the Dominican Republic, but it is important to know that midwifery is not an official profession and therefore there are no set rules for it.
• An appointment with a gynecologist costs approximately between 18 and 110 USD. The cost of a delivery is between 1200 and 7000 USD depending on the private clinic you go to.
• Abortion is only legal when the mother's life is in danger.

How safe or unsafe is a trip or stay in the Dominican Republic?

What should you pay attention to in terms of safety in the Dominican Republic?

• In the Dominican Republic, it’s better to be careful. Crime rates are quite high and robberies and pickpocketing are common in tourist areas, airports and busterminals.
• Theft from a motorbike or scooter is also a common phenomenon… It is best not to use your valuables openly on the street and to have a secured bag.
• Women are sometimes the victims of sexual abuse, also in the nightlife scene. It is therefore better to avoid travelling, walking and running alone, especially at night.
• There is a lot of ATM and credit card fraud.
• Storms occur throughout the year, which can cause landslides and flooding. So make sure you know what to do in these situations. 
• Earthquakes also occur. At such times, keep a close eye on the tsunami warnings!

What should you look out for in terms of diseases in the Dominican Republic?

• It is not uncommon for people to contract a mosquito-borne disease, especially from May to November. Diseases that are present are dengue, chikungunya and zika.
• Malaria is less common, but it occurs on certain parts of the island.
• HIV/AIDS is relatively common, so be aware of this.
• The risk of rabies is high. So make sure you seek medical help immediately if you are bitten or scratched by a dog, cat or even a mongoose!
• Another risk in the Dominican Republic is Cholera. If you do not treat Cholera, it can be fatal!
• Infectious diseases also occur. Be careful with food and always check whether the tap water is drinkable (it generally is not).

What should you pay attention to when it comes to traffic in the Dominican Republic?

• Let's get straight to the point - there are many traffic accidents in the Dominican Republic, especially during the holidays.
• Drivers hardly follow the rules. Driving with alcohol in your system is not uncommon and many indicators in the country seem to have retired. Unfortunately, there is also a lot of theft of cars. It is even possible that a scooter drives by and grabs something from the car. So keep the windows closed!
• The major roads are generally in good condition, but outside of that the roads are often left to their own devices.
• There are many military roadblocks, especially near Haiti.
• Public bus transport is reasonably well organised. Make sure you take a private intercity bus, from a good company. “Gua-guas” and “carros publicos” are not recommended.
• Taxis generally do not have a meter. Only use official taxis and agree on a price before you get in.
• Robberies in taxis (but also private cars) are common. You may be stopped by armed robbers on the side of the road, or someone who pretends to want to share a taxi has a deal with your taxi driver and they both end up stealing your things. 

What work and travel insurance policies are suitable for short and long stays in the Dominican Republic?

• Is the trip to and your return sufficiently covered? Are you sufficiently covered before, during and after your activities? Which insurance best suits your trip and your activity? Read more about insurances for abroad on JoHoinsurances.org.

What emigration and expat insurance can you take out for the Dominican Republic if you are going to live there for a while?

• Your own, international health insurance is important to prevent the high costs of private care and possible medical evacuation (because this can unfortunately be necessary).
• So, make sure your insurance covers medical evacuation as well as coverage in neighboring countries. Read more about insurances for abroad on Expatinsurances.org.