The Healthcare System in the Dominican Republic: Organisation, Local Insurance, Hospitals, Emergencies and Health Risks

The SDSS, created by Law No. 87-01, is organised into three financing schemes under article 7 of the law, published by the National Social Security Council (CNSS). The contributory scheme covers public and private employees and employers, with contributions from workers and employers. The subsidised scheme protects self-employed workers with unstable income below the national minimum wage, the unemployed, people with disabilities and people in destitution; it is funded mainly by the State. The contributory-subsidised scheme is aimed at self-employed professionals and technicians and at self-employed workers whose average income reaches at least one national minimum wage, with a contribution from the worker and State aid that replaces the employer share.

The health component, family health insurance (SFS), comes with old-age, invalidity and survivors insurance and, for the contributory scheme, occupational risks. The Social Security Treasury (TSS) collects the contributions. The CNSS home page also mentions a high-cost medicines fund (FOMAC), presented as covering thirteen medicines at 100%. Comparisons with the French system, or with those of other countries in the Americas, are in the guide to healthcare systems around the world.

The National Health Service (SNS) runs the public network of health services. In a publication of 25 June 2024, it states that it inaugurated or renovated, over the previous four years, 51 public hospitals and more than 570 primary care centres across the territory, with investments of more than 2 billion pesos since 2020. The works cited include neonatal intensive care, oncology and diabetic foot units, as well as hospitals in Santo Domingo, Santiago and several provinces.

These figures show a modernisation effort. The official sources consulted do not detail the conditions of access for a foreigner not affiliated to the public network. France Diplomatie indicates for its part that public hospitals lack the resources to handle emergency cases and that hospitals frequently refuse to discharge a patient until all the costs have been paid.

Two routes exist for a French resident. The first is formal employment: the TSS indicates that a foreigner obtains a social security affiliation number if they hold a work visa, a migration card or a regularisation card; a foreigner with only a passport does not contribute to the SDSS and receives no benefits from it. The health contribution of the contributory scheme reaches 10.13% of salary, of which 3.04% is paid by the employee and 7.09% by the employer, within a ceiling of 232,230 pesos of monthly salary since 1 February 2026.

The second is the SeNaSa Larimar voluntary plan. SeNaSa is the Dominican public insurer; its Larimar plan is aimed at Dominicans, at foreigners (naturalised or holding a passport) who want an individual plan and at the diaspora. The SeNaSa page specifies that you must be over 18, present an identity document or a passport and not already be affiliated, as policyholder or as dependant, to another plan; the file is processed within 15 working days. Payment is made in advance by quarter, half-year or year, and the plan page mentions a medical check-up from age 55. The catalogue includes more than 3,000 health services, delivered by about 8,000 providers: doctors, clinics, laboratories and diagnostic centres.

Contribution amounts are not published on the pages read; they are obtained from SeNaSa. Coordination with other cover is explained in healthcare reimbursement in the Dominican Republic.

The plan’s official page presents the following guarantees, which policyholders compare against their needs before signing up:

• unlimited medical consultations, with a co-payment that varies by type of consultation;
• 80% of laboratory and imaging tests;
• 100% of emergencies in contracted centres;
• 100% of hospitalisation up to 3,000 pesos a day;
• 80% of medicines at the pharmacy, up to 4,000 pesos a year;
• maternity covered at 100%;
• high-cost diseases: ceiling of 500,000 pesos.

These ceilings, expressed in pesos, should be set against the fees of a private establishment: a daily hospitalisation ceiling of 3,000 pesos can leave a remaining cost to pay if the room or procedures exceed that amount. Waiting periods and exclusions do not appear on the pages read; they should be requested from SeNaSa before the advance payment, by quarter, half-year or year. The notions of out-of-pocket cost and reimbursement basis help you read a table of guarantees.

The SNS primary care centres form the first level of the public network. The private sector requires, according to France Diplomatie, advance payment or proof of insurance before any care is provided. The official sources consulted do not describe a compulsory care pathway with a registered doctor; the SeNaSa Larimar plan gives access to a network of about 8,000 private providers, including clinics and laboratories, which the policyholder consults directly.

Before a planned hospital stay, three checks avoid unpleasant surprises: the insurer’s agreement to cover the costs, the amount of the deposit requested by the establishment and how direct payment works. The guide to checking the contracted network details the method.

911 is the single emergency number: police, fire brigade and medical rescue, free call. The Casa de Conductores handles procedures after a road accident (Santo Domingo: +1 809 381 2424; Santiago: +1 809 241 4848). France Diplomatie recommends a policy covering medical costs, surgery, hospitalisation and medical evacuation, since the embassy cannot bear these costs. See how a medical repatriation works.

For medicines, the SeNaSa Larimar plan indicates 80% cover at the pharmacy up to an annual ceiling of 4,000 pesos, and the CNSS cites its high-cost fund for thirteen medicines. Regular treatment should be prepared before departure, with the prescription and the international non-proprietary name of the medicine.

France Diplomatie recommends updating routine vaccinations (diphtheria, tetanus, poliomyelitis, whooping cough, measles) and mentions as recommended hepatitis A, typhoid fever, hepatitis B, tuberculosis for children under 15, rabies, chikungunya and dengue. Yellow fever vaccination is required of travellers coming from endemic areas.

• Dengue and chikungunya: the country is experiencing a surge of dengue, notably in Santo Domingo and Barahona; protection against mosquitoes is part of daily life. Zika calls for a doctor’s advice for pregnant women.
• Malaria: year-round risk in the western provinces (Dajabón, Elías Piña, San Juan); no risk in Santo Domingo, Santiago and Punta Cana.
• Water and food: drink bottled water, peel fruit and vegetables, avoid raw food and cook meat and fish thoroughly. Cholera, ciguatera, typhoid fever and leptospirosis are also cited.
• Rabies: cases are reported; the anti-rabies centre answers on +1 809 681 1637.