Insurance in CR

Try:   MediSmart.net.

Medismart is a good option, but understand that it is a discount program rather than a health insurer.

We have been covered by Redbridge (based in the U.S.) for a number of years. They offer a typical array of coverages and deductibles at a variety of costs. Two years ago, I was hospitalized at CIMA Hospital in Escazu for over a month and Redbridge paid the entire cost except for the deductible. You can learn more by contacting Perfect Circle which is Redbridge's agent and representative in Costa Rica.

https://www.perfectcircle.life/contacto

@daveandmarcia

Hello Dave.

Great info. 

I'd like to ask you a few questions and you need not entertain them, but I come from a blood line where Heart issues are the norm, and I don't want to find myself unprepared...

Here goes:

1. When you were hospitalized (and before) were you 'in' the CR 'Caja' already; and additionally, carried Redbridge as 'extra' healthcare coverage in case of something major; and for peace of mind??
2. What are your Redbridge premiums per month per person... and how much did they go up (if at all) after your surgery and recovery?
3. this one is only if you are a Resident... Have you considered letting your Residency expire and just do the 6-month border run or fly out and just keep Redbridge for your healthcare, and get rid of the Caja?? 

         I've been considering doing just that...  where I live the 'Caja' isn't great.  The doctors 'hate' coming to the little villages and despise the 'country' folks who live here... almost as if they drew the 'Short Straw' and ended up with the least attractive 'assignment'   With the new 180-day Visa stamps, it seems that I'd be better cared for when needed, and use the Visa requirement to do some short, 3-4 day vacations to Colombia, and other destinations.

Gracias

Hi, rainagain,

To answer two of your questions, first, we are naturalized citizens of Costa Rica.* As such, we are not required to be enrolled in the CAJA and, in fact, we are not. We bailed out in 2018.

Second, two years ago, I was hospitalized for just over a month at CIMA Hospital in Escazu. At that time, we were not enrolled in the CAJA**, but we did have insurance coverage provided by Redbridge via their Perfect Circle costarican agent. (See above.)

To get a meaningful answer about monthly premiums, you'd have to contact Perfect Circle. We are likely older than you which makes a difference; there are two of us, which makes a difference; and I am diabetic, which also makes a difference. There's no way for me to parse out what your cost might be at your age and in your state of health. They do require a pre-insurance physical exam and history.

Our premiums have gone up every year as we have aged and as their losses have varied. Our premium did not go up a great deal after my hospitalization. I was hospitalized in October of 2022 and our premium year runs October 1 through September 30, so the 2022-23 premium had  already been set. If you purchase health insurance from Redbridge by some stated age***, then they will continue to insure you 'til death do you part.

Seeking to avoid relying on the CAJA****, we have always paid for normal outpatient care (lab, pharmacy, office visits, etc) and need Redbridge only for major events.They will pay some part of outpatient care but we've never investigated that coverage.*****  When I got sick, they came through after a bit of arm twisting by the admitting physician at CIMA. We're careful to "charge" all our cash payments for health care to IRS.

Whether you'd be cared for better by relying on a commercial insurer versus the CAJA is anybody's guess. Both rely on the actual existence of the resources you need and the accessibility of those resources. The CAJA may have the best cardiac diagnostic equipment, for example, but if it's all centered in San Jose, is it really accessible to you? And what's the wait time?

Note: CIMA Hospital offers several levels of preventive care diagnostic packages. The more tests the more they cost. If you're a potential cardiac patient, it might be money and time well spent to schedule yourself into CIMA and get the full treatment.

*Costa Rica and the United States both permit dual citizenship, so we have both.

**Costa Rican citizens don't have to participate in the CAJA.

***Some commercial insurance companies will terminate coverage when you reach a stated age. Redbridge says we'll be covered for as long as     we pay the premiums or until we die.

****As best I can tell, the CAJA functions much like a bad American HMO which I want no part of. Among other things, I'm a doctor-shopper.

*****I hate bureaucracy and paperwork.

@daveandmarcia

You are the best!!!   Thank you so much for taking the time to answer.

Happy Halloween and all those other upcoming Holidays.

Peace to you and the Mrs.