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how difficult it will be to get insurance

Gay couple from the midwest of the USA.  Looking to relocate to CR.  Will be able to relocate in 2019.  Both of us early 60s.  Spouse has type 1 diabetes controlled with an insulin pump and transverse myelitis, (which is kinda like 1 episode of multiple sclerosis).  Will start searching the forums but our biggest questions are how difficult it will be to get insurance to cover his conditions and are insulin pumps and infusions sets available there?  Would we be able to get health insurance for the pre existing conditions as soon as we became residents?  Thanks for any help.  I'll start searching the forums.

Our decision to move is an easy one.  Unless we win the lottery we won't be able to live comfortably in the US.  With the husbands health issue his life expectancy is shorter so we might as well retire when he turns 62 and enjoy the rest of our lives.  Other wise I have to work another 10 years just to be able to afford to stay here.

miket2937 :

Gay couple from the midwest of the USA.  Looking to relocate to CR.  Will be able to relocate in 2019.  Both of us early 60s.  Spouse has type 1 diabetes controlled with an insulin pump and transverse myelitis, (which is kinda like 1 episode of multiple sclerosis).  Will start searching the forums but our biggest questions are how difficult it will be to get insurance to cover his conditions and are insulin pumps and infusions sets available there?  Would we be able to get health insurance for the pre existing conditions as soon as we became residents?  Thanks for any help.  I'll start searching the forums.

Our decision to move is an easy one.  Unless we win the lottery we won't be able to live comfortably in the US.  With the husbands health issue his life expectancy is shorter so we might as well retire when he turns 62 and enjoy the rest of our lives.  Other wise I have to work another 10 years just to be able to afford to stay here.

Hola!

On the subject of pre-existing medical conditions, I don't know if that would be allowed with CAJA (CR health care system) or not.  Kohlerias, or anyone else, do you know the answer to this one?

Re the insulin pumps and infusion sets.  Someone asked this several months ago and I checked with one of the pharmacies that we use.  The do carry these.

As to moving here for financial reasons.  You'll find varying opinions on this, but, my personal opinion is that it is more expensive to live here than it is in the States.  At the same time, due to the health issues you mention, IF you are able to obtain CAJA with a pre-existing condition, it may be less expensive. 

To form an accurate view of the cost of living, you would need to spend some time here and look into the costs for "your" lifestyle.  Food costs can be higher, depending on what you choose to eat.  Cars are about double what they cost in the States.  Again, depends on what you choose to drive, etc., etc. 

Hope this helps.

- Expat Dave

You will encounter a few problems...

Your marriage will not be recognized here, which means you both will be required to apply separately for Pensionista status; that is with your own 'guaranteed for life' pension', of at least us$1000 per month.

It also means you will both required to have separate health care accounts.

CAJA does not discriminate with pre-existing conditions...however, all diabetic needs may not be covered so you will be then required to purchase them...if you can find them...'over the counter' in some areas...

If symptoms similar to multiple sclerosis is in your husbands future, know that most sidewalks are in terrible condition here and wheelchairs are usually used on the road.

Thanks for your reply.  We currently spend about $20,000 per year for insurance plus $6000 for deductibles.  I would hope living there would provide us with significant savings just on this alone.  Are prices for everything expensive?  If we insist on buying what we are used to in the US I assume it might be as expensive or more so.. If we were to live simpler, eat what the locals eat, etc. would it still be more expensive?  We don't eat out or even go out for entertainment because of my spouses health.  I was hoping we could afford to higher a housekeeper/cook who could help us.  Are they expensive?

I know this is alot of questions but would appreciate any insight you can provide.  I would suspect we would end up in the central valley though not necessarily right in San Jose, perhaps Cartago or  Grecia.  We of course don't know for sure because we've never been there.  A primary consideration is a constant moderate temperature as excess heat aggravates my spouses MS type symptoms.

I would suggest, that you visit extensively before making any decisions.

It could take a year or more to be covered by CAJA the socialized medical system and after that it can take a  'l-o-n-g'  time to arrange tests and/or see a specialist, so this is when many expats choose to use the private facilities. 

The CAJA facilities vary from being  'good' to being 'below par'...so it would depend on what is acceptable to you both. You cannot choose your doctor and must use the one in your assigned neighborhood unless transferred to one on the larger hospitals.

Visitation would not be a problem, except they only are open for a specific hour.

Eating like a local usually just include eating more fruit. rice and beans...but suggest less fried foods, white bread, sugar and natilla similar to sour cream that they love!

Hi Freedaagain:
MY advice would be to wait another 8 years, then start your investigations..
A Lot can change in that time including your mind. why boggle your mind at this stage of your life?
Live and enjoy UNTIL you are nearing retirement. OR maybe take a trip or two to see whether you even like Costa Rica.

I agree with Kohlerias on coming down and doing a lot of research.  If you are spending $26,000.00 per year on medicals, you may be able to save quite a bit here. 

As mentioned, it will take about a year to obtain your Cedulas, residency, before you are able to use the healthcare system here for free.  At the same time you can use private doctors and hospitals.  They are MUCH cheaper than what you'd pay in the States. 

As an example, I recently spent a whole day being treated by a private physician for a kidney stone.  Included constant nursing care, hours with the doctor, ultra sound, meds all day, etc.  The total cost was $400.  This included a follow-up visit with the doctor for over an hour.  This is not something any doctor would even do in the States.  If they did it would cost a fortune.

There are two totally different types of medical care here, CAJA and private.  Appointments for CAJA hospitals/doctors, especially specialist can take months.  They also do not offer the higher standard that the private hospitals/doctors offer.  F.Y.I. - The private care here is rated higher then that of the U.S.

The three private and highly rated hospitals are:
Clinica Biblica Hospital
San José, Costa Rica · +506 2522 1000

Hospital CIMA Guanacaste
Provincia de Guanacaste, Comunidad, Costa Rica · +506 2690 8500

Hospital La Catolica
San José Province, Guadalupe, Costa Rica · +506 2246 3000

For anyone, it is important to spend as much time as you can researching your medical care prior to moving down.  Do not assume that the medications that you need are available here.

- Expat Dave

The main CIMAhospital in is San José, and you will be transferred there, at your expense of course,  for serious conditions.

REMEMBER That  "CIMA"  WAY out in Santa Ana ,  and is THE most expensive private hospitals in Costa Rica (and the world)  Slightly cheaper but great doctors and lovely ambiance is  "Hospital la Catolica" just on the fringe of San Jose in decent area ) next best with reasonable prices is Clinica Biblica in San Jose  Centre on Ave 14 ..Good Luck I live close to them  within 20/30 mins and KNOW them all WELL and  MANY of their doctors from all 3 hospitals  are friends of mine ...all PM me if you have more questions...

SORRY but CIMA Hospital is NOT in San Jose but way out in Santa Ana A Big difference in location!  and PRICE  to the other 2  that I know .and mentioned as as nice and slightly cheaper "Clinica Catolica", in Guadalupe (the outskirts of San Jose ) , and Clinica Biblica in San Jose Center ( Avenida 14 .
I have been a patient of all 3 , know them all well and have doctor friends in all 3  hospitals rated all as excellent but in order of  less expensive and closer than CIMA

Hi If after doing a lot of research you choose Costa Rica...You or your husband can not just "go out and find work in Costa  Rica THERE ARE hundreds  of people working online to make extra money OR if you buy a  property with a commercial business license and health permit  (or go through the legal process to get one ) ...you CAN open your own B&B or rent monthly apartments
It would be advisable to do as I did and spend over $200,000 IT  will make it easier to get your permanent residency ..Good Luck .If you choose Hawaii as many of  my friends did, and are sorry,  and are amazed at the high COST OF LIVING,,,so it is hard to compare the 2 as Hawaii is still as you know the USA

I 'took' the 'San Jose' location, off of their website.

Hi Miket2937,

Please note that a new thread has been created with your posts on the Costa Rica forum.

Here it will be easier for you to communicate with the members.

Thanks,

Priscilla

As I read what you have said, you have  3 reasons for looking at moving.  Cost of living, cost of healthcare and a 'constant moderate temperature'.   

You do not believe you can get that in the USA and have identified CR as a potential place to move to, where you can get that.

First, I would question the climate issue.  Temperature averages tell you nothing about humidity.  Most people prefer a humidity level of 30-50.  As you will see, that is not what you can expect to find in CR.  https://www.currentresults.com/Weather/ … verage.php

My understanding and I am certainly no expert on the subject, is that not only heat but humidity affects MS symptoms.
http://onlinelibrary.wiley.com/doi/10.1 … .91.04/pdf

It also affects Diabetes:
http://diabetes.sanofi.us/dear-diabetes-weather/

So I would first question whether you can find what you want in CR in regards to that.  I'm not saying you can or you can't, I'm just saying you need to know.  I have not lived in CR, only visited but my understanding is that humidity is generally high.  Those living there and posting here can give you more info on that obviously.

Next, regarding cost of living and cost of healthcare.  Whenever someone asks questions about those topics and any country, I always find it easier to start from the other end of the stick.  What I mean is that if you tell us what your income will be if you both retire in 2019, it may be that people can immediately say, no.

Getting into details of costs if that is the case, is a waste of time.  For example, if you say you will have a combined income of $20k per year and that has to cover everything from rent to healthcare, those living there may say it simply isn't enough.  In which case, the details don't matter.  So why not start by giving that information and see if it is still worth continuing to ask detailed questions?

To me it doesn't sound like you have any actual real reasons for WANTING to live in Costa Rica.  It isn't a place you have visited and fallen in love with for example.  It is more of a place where you think you might be able to afford to live and that is your only real reason for looking at it at all.

If that is the case, it might make some sense to back up and say where are any countries where you can afford to live.

One other thought about potential places to move to where universal healthcare is seen as a human right.

Do either of you have a parent or grandparent born in another country?  For example, that can get you the right to live in most European countries and all of them provide healthcare for everyone.

I really feel sorry for Americans in regards to healthcare.  The USA is the only first world country that does not see it as a human right.

Hello,

I have been trying to get concrete information about CAJA, but I keep getting mixed data.
How much would it cost to pay CAJA for a person under 30 as a rentista resident?

Thank you!

It does not matter what you research and read but the bottom line is that there is no set amount.  Different Caja offices do not ask for the same information from applicants and therefore there is no fixed table.  The best determination is to ask what others pay and take an average and at best that is just a guess.  We applied as Inversionistas and were warned that this was the most expensive category for Caja.  We ended up paying less than one tenth of what our acquaintances pay under similar circumstances.  Two entirely different Caja districts.

TerrynViv is quite right...no one knows for sure until the very end of the application procedure, however, since you will have US$2500 automatically transferred every month from the cost of living account that is from the initial funds that you deposited, this is what CAJA will base your premium on.

If are under 55 your premium will be approx. double that of someone older than 55, since you will be paying into the pension fund.

Expect your monthly payment to be high.

I will ask around, good idea!
Thank you very  much for your insight!

Guacara :

Hello,

I have been trying to get concrete information about CAJA, but I keep getting mixed data.
How much would it cost to pay CAJA for a person under 30 as a rentista resident?

Thank you!

I would recommend using an attorney to set it up when you reach that point.  Or someone who's familiar with the process.  I had my attorney re-negotiate my CAJA after paying in for several years.  He got it down to less than half of what it was.  They have a better understanding of what can be used to offset your monthly fee - allowable deductions.

- Expat Dave

Gracias!

Once  a Permanent resident, you can apply for a lower rate for your CAJA coverage,

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