The Dominican Republic’s health care system is three-tiered. At the bottom, the poorest in society are guaranteed access to free, socialised care.
The reality however, is that most still end up paying out-of-pocket expenditures for medical supplies and various services. This can be explained by the fact that the government only devotes around 1% of GDP to health care, resulting in over half of all health expenses being funded by the people themselves.
Those who earn less than RD $4,000 per month are also covered automatically. This cover, however, only extends to the worker and not their family; though it does include maternity care for a spouse.
Those who do not fall into either of these categories must pay their own medical fees. You may work for a company which provides an iguala, which means medical cover at a private, local clinic at no additional cost. There are limitations however - if your clinic does not have the specialist you require, you’ll be forced to visit another clinic where you aren’t covered, thus incurring the costs yourself.