Health insurance

1. If you currently have Medicare in the USA, you could keep Parts A & B and plan to fly back to the USA for high cost medical treatment (excluding emergency care).

2. You could self-pay for private  medical care in Costa Rica, as such costs are much less than in the USA. 

3,  You could purchase an international health care policy that either includes or excludes the USA.

4. Currently you need to maintain health insurance satisfying the Affordable Care Act in the USA for some time period, although that may change soon.

I have a high deductible ($5000) international health care policy and will be eligible for Medicare later this year.  Currently my policy covers in the USA but I plan to remove the USA from my policy once I am on Medicare.  I have Rentista Residency and pay into the public health care system in CR also.  I get prescriptions and routine medical care from the local public clinic, but I plan to use private care facilities for other health needs.

I agree with Redbeards suggestions.  I would also say that it all depends on what you want to cover and your financial situation.

If something major happens and you need 'immediate' medical care, you will not be able to return to the States to use Medicare.

Once you have residency here, you will be eligible for the CAJA which cover most anything; however, for anything major you would go there only as a last resort.  CAJA medical care can kill you if you use it in an extreme emergency.  This happened to a friend of mine just a few months ago; yes, he actually died due to the horrid treatment he received from the CAJA hospital.  By the time he was sent by ambulance to CIMA, a very respectable hospital, it was too late.

I have Medicare if I need it and can make it back to the States.  If not, I keep $30,000.00 set aside for emergency medical care here.  To seek emergency "critical care" here at one of the major and good hospitals, you will be required to deposit $7,000.00 by cash or credit card before you can be admitted.

As Redbeard also said, the other option is international health insurance.  I used to have Cigna with 100% coverage.  I paid $250 per month with a maximum copay of $2,000. per year and millions in coverage - don't remember exactly how much it was.  It can be used in any country in the world with the exception of the U.S.  If you do the research, you'll find that the U.S. medical care is rated poorly anyway.  And of course cost more than most other countries.  (According to WHO, the U.S. actually ranks below Costa Rica in health care.)  Not sure I could agree with that one.

One thing I strongly recommend is that you visit the major hospitals in advance.  Know where they are, know who to contact if you need emergency transport, where to go in an emergency and talk to them directly about what they offer.

The three major hospitals with high ranking medical care are:

Hospital CIMA in Escazu
Hospital Clinica Biblica in San Jose
Hospital Clinica La Catolica in Guadalupe, San Jose

- Expat Dave

Red beard, thank so much for the rapid response. So may things to think about. Much appreciated.

Thanks Dave, this is certainly more info tan I can find online. We're coming down in June to make some further plans for our move. Thanks so much for your help. Kevin

Hola Kevin,

If you have any questions at all, please just ask.  You will find good medical care here.  It will simply be a matter of finding what fits your needs.  My personal opinion and recommendation, as I stated before, DO NOT rely on CAJA medical care for anything serious.

I know exactly how it feels at first.  It is not at all as overwhelming as it seems.  Coming from the States and knowing the mentality that we incur growing up.  We have this need or thinking to have everything planned out, to have it done "on time," to be done quickly and in order.  It does not need to be that way at all.  Coming down here it is much easier if you can come with the understanding that you need to take your time and relax.  Both mentally and physically. 

You will need to, or maybe even have to change the way that you think and react to your environment.  Things do not happen here "on time," "on schedule."  It's a necessity to learn to take your time and enjoy the moments and laugh at the bits of insanity.

- Expat Dave

It seems impossible to get insurance coverage for pre existing conditions thru private insurance.  My spouse has type 1 diabetes.  We had considered Mexico and Spain for relocation but can't figure out how we could get insurance with his pre existing issues.  Suggestions on getting good health care in CR?  Thanks for your responses...

I'm moving to Costa Rica this summer. We have taken a policy with Cigna Global ex U.S.
I am also a recently retired Physician from south Florida and practiced in Cardiology as well as Internal Medicine. Unfortunately, the comorbidities associated with Insulin Dependent Diabetes are many, most of which are vascular in origin. Strokes, Heart Attacks, and PAD are just a few of the problems that an insurer is dealing with. Mention an organ including the skin and I can give you a grocery list of maladies. The least of a diabetics problems is there A1C. Type II brings the same problems but with neuropathy and visual problems. I'm sure that your premiums are high but with IDDM you may not be able to get a policy abroad. For "permanency" in CR you must be seen by a CAJA physician and pronounced healthy for your age without significant diseases. Good Luck

Can you please explain, your statement " For "permanency" in CR you must be seen by a CAJA physician and pronounced healthy for your age without significant diseases".

kohlerias wrote:

Can you please explain, your statement " For "permanency" in CR you must be seen by a CAJA physician and pronounced healthy for your age without significant diseases".

I did not have to see a physician to qualify for CAJA.  Once we had our Cedulas, we simply filled out the paper work, payed the fee and had it.

- Expat Dave

Yes, if that he meant, it is wrong. Private inurance companies will require you have a medical and they will decide by whom...
We are Permanent Residents and did not require and did not require any additional medical exams.

Have you read the laws on permanent residence in C.R. I have had the good fortune to be able to afford to have them sent to me in English by my attorney and have read them thoroughly. It seems as though some like to learn things as they go along. Significant diseases for age would be that of significant COPD (Chronic Obstructive Pulmonary Disease) in a 65 yo male. CAJA would have to provide both his many inhalers, steroids for exacerbations, expensive antibiotics. The converse would be a 65 yo male who quit smoking at the age of 35, does cardiopulmonary exercise three days per week yet continues with mild hypertension due to salt sensitivity, he has two medicines to control his hypertension. What they do not want is a bill in their migration mailbox. If you smoke, forget even applying if you tell the physician that you are a smoker. Age is always a consideration to this government because they want you to contribute to the economy. I'll be going back down in May and visit with my attorney and will ask if he can be more specific on this issue. I'll give ya a shout.

I don't know who your lawyer is,  but this information is TOTALLY wrong.

As mentioned before, a medical is not necessary or required when signing up for CAJA ... and as long as you pay your monthly premium ...  which is required as it is mandatatory to gaining residency... you will be treated with no additional expense, unless your meds are not one the meds., that are prescribed at no cost and some generics are used If you have not paid by the due date, it is possible that  you will be refused treatment.

INS, the private insurance  provider here, has strict guidelines, so maybe you are getting confused with the two and the info you are getting.

Thank you for the assistance and poor sense of English composition. I'm moving to CR without difficulty. I can only impart what I know or possibly what I think I know. A former patient of mine moved 2 years ago and was turned away until she could present a physical exam performed by a CR licensed physician. Your credentials are?

929292Aaa!, I am not sure what you mean that your former patient was "turned away" by CAJA.  Once a resident and paying for CAJA, they should not be able to "turn away" a patient.  But that does not guarantee that they will immediately treat a medical issue that the patient claims to have.  They will require a CR specialist to confirm the medical issue and then determine what medical assistance that they will provide.  In that case, yes she will need to be examined by a CR licensed physician.

Maybe your former patient hadn't signed up for CAJA?

FYI, it takes approx. 5 years to become a Permanent Resident from the initial application.

No credentials... only experience with CAJA for many years with  nothing to sell, only offering assistance.

So the "residency" that enables you to get health insurance is the 5 year version.. not the one from the Visa you can get prior to or just after moving into the country?

Thanks to all of you for your insights..