New CAJA rules apply...

158POSTS

11 years ago

At least this is what is being repeated by those who have gone to renew their CAJA and have been told that spouses must have their own account and pay an additional premium. This seems to apply to both legal Residents and Costa Rican citizens

See also

Pregnancy and birth in Costa Rica - Guide
Information required on CAJA payment - 2 Replies
HOW (step-by-step instructions) to apply for a pensionado visa - 18 Replies
Form Needed for Erasing CAJA Payments for the Months out of Costa Rica - 6 Replies
Caja payment - 7 Replies
Caja price - 2 Replies
Monthly CAJA payment - 42 Replies

Gr8fulmom Active member

35POSTS

11 years ago

I am trying to get info on current caja premiums. We are doing our residency application and now I understand the rules changed this year and the prices are much higher! How does it work? Where can I find info? Thanks

Edward1958 Guest

0POSTS

11 years ago

You must sit with an official and explain your situation, and then a rate is given. Two couples with the same reported pension income can be the same, and yet the premiums they pay could be totally different. One thing is for sure... Do not produce more than $1,000 pension income when applying for Pensionado status, if you have a pension in that area. When you attend the interview dress in old clothing. If one of you are on any sort of medications bring it to the interviewers attention, if your financial needs are great your premium will be lower, especially for medications. If you are a Rentista and have declared a big pension income "get ready to pay huge premiums", one couple who reported a large pension income was given a premium of over $700. so they left Costa Rica. Canadian's do not understand paying for health insurance (like myself), as we have had free health insurance in Canada all our lives. Just remember, there is no chart which shows how much you till pay, it is based totally by what the interviewer thinks you can afford. Of course there is a maximum for the pension income amount you reported, but don't show wealth during the interview and you'll pay a lower premium.

cupacoffee Contributor

158POSTS

11 years ago

If the principal applicant is using one pension to apply as a Pensionado, and which must be at least $1000 you have to show an Authenticated (Canada) or Apostilled by the State’s Secretary of State (USA) in which the documents were originally issued. Then, when renewing you will also have to produce a new 'up to date, authenticated or apostilled copy' so you cannot just tell them, $1050 per month. If your pension used for the application, is $3000, then that is what your premium will be based on.

The staff is not stupid, so don't 'dress in old clothes...

Here is a link, that show some rates...but it is already out of date. Going direct through CAJA may result in a lower fee but you will have to deal with the staff there. Recently, spouses have been told they must have their own account, but ARCR are presently trying to see exactly what is happening and are preparing to stand up on our account.
Rentistas and Investors rates are devised, differently and you cannot claim any expenses.

Gr8fulmom Active member

35POSTS

11 years ago

We are getting investor status.

Is it your total income worldwide or what you bring into CR?

We live in Canada half the year (by the way as a bc resident my fany pays $150 per month in bc health care it's different in every province plus we pay for extended)

I also understand it drops once you get permanent residency?

This is quite confusing!

Edward1958 Guest

0POSTS

11 years ago

If you have two pensions... If one is $1,000 per month, and the other is $2,000 per month, you of course present the $1,000 pension when you apply for status. They want to make sure you have the minimum required amount in order to qualify for status, you are not required to provide information on your other worldly investments and incomes.

Gr8fulmom Active member

35POSTS

11 years ago

I have no pension.
We are applying as investors.

Also we are a family with 3 kids who are all dependents under 18.

cupacoffee Contributor

158POSTS

11 years ago

As investors you may receive a very nasty surprise of a premium of approx $700 per month and possibly even higher, if you are under 55 And as mentioned, you may be required to have your own CAJA account...as may your children, when they reach 18 and are not continuing their education, here in Costa Rica. If you have no income, CAJA will provide you with set fee, according to some reports.

Link to more info

kohlerias ViP

1572POSTS

11 years ago

It will probably take 5 years from your initial application until you will be granted Permanent Residency status, if you decide to do so, so you can't expect lower monthly premiums until then and by then the requirements, regulations and rates will have changed.
Unfortunately, like many expats, you could decide not to make use of the CAJA facilities and have to pay for private services rendered.

Gr8fulmom Active member

35POSTS

11 years ago

#10

I think caja is a requirement of doing residency right now…

I am told it is only your income in CR that counts…

very confusing!

kohlerias ViP

1572POSTS

11 years ago

#11

Yes, CAJA is mantadory for residency, however, first you get Temporary Residency and you cannot apply for Permanent residency until the beginning of your 4th year in this status, and then it could take a year to get PR.
Your premium will be based on how much your 'Investment' is worth. I would suspect you are using a house that you intend to purchase or have already purchased that is at worth at least $200K..and since CAJA has access to your residency files, they know you have money...and you can't claim any living expenses.

You funds in Canada or elsewhere, does not come into their equation.

Edward1958 Guest

0POSTS

11 years ago

#12

You will find that almost everything here in Costa Rica is confusing, even for the Ticos.
It took me over a year before the bank would allow me to open an account. If you go into a bank and ask three tellers the same question you'll get three different answers, that's just the way things operate here. You should be able to ask what your CAJA premium will be if you apply for Pensionado residency with a certain amount of pension income, "but they won't give you an answer" until you've actually secured residency. A major mistake can be by declaring your entire worldly monthly income, when you are only required to produce a legal document indicating you will receive a minimum of $1,000US per month. One Canadian couple had their combined CAJA premium increased to over $700. per month, so they left and are now in a different Central American country. American's are accustom to paying high medical premiums, where us Canadian's are not. You might want to see this short video> https://www.youtube.com/watch?v=Fou20wUrVpI

Edward1958 Guest

0POSTS

11 years ago

#13

I have no knowledge with how much people pay for CAJA medical coverage when the come in as investors. I heard that the premium is high, but I don't know for sure. You might want to look at Bupa insurance, but then as investors you may be required to buy CAJA. http://www.ihi.com/
You might also wish to see this short video... https://www.youtube.com/watch?v=6K_n0FNqDg4

Edward1958 Guest

0POSTS

11 years ago

#14

This whole residency thing is expensive, confusing, and controlling, which is why such a high percentage of foreigners just buy Puba insurance and cross the border every 90 days. In regards to investors, I think they'd better see this video before making a decision to invest in Costa Rica. https://www.youtube.com/watch?v=6K_n0FNqDg4

kohlerias ViP

1572POSTS

11 years ago

#15

Anyone with legal residency, such as Pensionado, Rentista, Investor or those on this list (not a tourist) are obligated to join CAJA.

Once you have lived here for 7 years, you can apply for citizenship and once obtained, you can 'opt out' your affiliation with.CAJA.

Edward1958 Guest

0POSTS

11 years ago

#16

I have a question: The cost of CAJA coverage should be available before applying for status, not after. What if you secure status "then discover that the premiums are too high for CAJA", is it possible to forfeit your status and go back to being a perpetual tourist?

Gr8fulmom Active member

35POSTS

11 years ago

#17

Actually, I found the whole residency thing very straight forward.
I have lived here almost 10 years part time and I get the pura vida way.

As I said before I pay provincial medical premiums in Canada anyways, so that's not new. It's province by province how its run.

I am only asking if anyone has actual experience with the NEW caja system (which began this year 2014) as investors…

I am getting some good info elsewhere that it won't be crazy high. The people who end up paying hundreds of $ seem to be the ones who muddled through and gave wrong or too much info and got messed up! I don't intend to have that happen

So again just wondering if anyone has any actual experience with this from this year!

I will be sure to share my experience as we go along!

Happily living part time in CR! Pura vida!

kohlerias ViP

1572POSTS

11 years ago

#18

Please do keep us up to date with the fees and remember the big difference is be due to the age of the principal applicant, which can double the 'hoped' for premium.

samramon ViP

1338POSTS

11 years ago

#19

Edward1958 wrote:
You will find that almost everything here in Costa Rica is confusing, even for the Ticos.
It took me over a year before the bank would allow me to open an account. If you go into a bank and ask three tellers the same question you'll get three different answers, that's just the way things operate here. You should be able to ask what your CAJA premium will be if you apply for Pensionado residency with a certain amount of pension income, "but they won't give you an answer" until you've actually secured residency. A major mistake can be by declaring your entire worldly monthly income, when you are only required to produce a legal document indicating you will receive a minimum of $1,000US per month. One Canadian couple had their combined CAJA premium increased to over $700. per month, so they left and are now in a different Central American country. American's are accustom to paying high medical premiums, where us Canadian's are not. You might want to see this short video> https://www.youtube.com/watch?v=Fou20wUrVpI

So, let me understand this:
If you are a couple where the main applicant, say the husband, is receiving $1200/mo soc. sec. that is ALL you have to report? They do not require a U.S. taxes document that shows what you made last year or this year, which also shows other income by the wife or by you ? And they don't then base the CAJA payment on the $1200 Social Security benefit PLUS other income you show on your last year's or this year's taxes?

If they don't I am very surprised by this, as it seems their whole point is to squeeze more money out of Americans who are expats and applying for residency...

cupacoffee Contributor

158POSTS

11 years ago

#20

At this point in time, CAJA will accept the amount of $1200 if that is what you used to apply for residency...but now, it seems that they are requiring the spouse to open their own account, even if they don't have an income... so CAJA will 'put an amount' of possibly 20,000 col per month. The principal account holder will have to produce a new certified copy of their 'pension check' showing the amount, when renewing your cedula
ARCR, amongst others, are trying to see whether this is legal or not but they expect it will take a few months to do so.

Edward1958 Guest

0POSTS

11 years ago

#21

If you have Pensionado status, how easy to get out of it? Is it possible to forfeit your status and go back to being a perpetual tourist?

cupacoffee Contributor

158POSTS

11 years ago

#22

You should check with a lawyer regarding this issue, as I'm sure, it is not an everyday occurrence with forum members.

Gr8fulmom Active member

35POSTS

11 years ago

#23

we have a lawyer… I was just hoping to get someone info from someone who had done it… I am hearing that it will be ok from someone I talked to in real life here… just need an advocate to go to help make arrangements….

cupacoffee Contributor

158POSTS

11 years ago

#24

gr8fulmom, I'm not sure what you are responding to by your comment "I am hearing that it will be ok from someone I talked to in real life here"?
I was referring to Edwards question of 'If you have Pensionado status, how eay to get out of it'?

Gr8fulmom Active member

35POSTS

11 years ago

#25

sorry i misunderstood

cupacoffee Contributor

158POSTS

11 years ago

#26

If you are referring to when you actually apply for CAJA, unless you are applying for Pensionado status, there are 'set premiums' based on the principal applicant and your cost-of-living expenses are not taken into consideration.

BTW, all CAJA premiums were raised as of Jan 1st. 2015 as I found out when I paid mine today, by varying percentages.

samramon ViP

1338POSTS

11 years ago

#27

Hey fellow forum members - it would be great if everyone would use that little QUOTE " button at the bottom right when replying to a post. That way we know exactly who and what you are replying to! ;-D

1 member reacted to this post

gypsy1 New member

5POSTS

11 years ago

#28

I just went on the Bupa site, and asked for a quote. The site came back with "there are restrictions with your country of residence". Do you know anything about this?

gypsy1 New member

5POSTS

11 years ago

#29

gypsy1 wrote:
I just went on the Bupa site, and asked for a quote. The site came back with "there are restrictions with your country of residence". Do you know anything about this?

samramon ViP

1338POSTS

11 years ago

#30

gypsy1 wrote:
I just went on the Bupa site, and asked for a quote. The site came back with "there are restrictions with your country of residence". Do you know anything about this?

No, but what is your country of residence? What is Bupa?

samramon ViP

1338POSTS

11 years ago

#31

By the way ladies and gentlemen, it seems that the new CAJA policy of charging spouses extra for CAJA is illegal - at least unless or until they make such a law. This was apparently resolved by Outlier legal service who we all owe a huge THANKS! JOB WELL DONE!

It was apparently based on a misinterpretation of the law by someone at CAJA and now that policy is being rescinded. This was reported by the ARCR in their forum. I won't give a link because it will no doubt be deleted or cause my post to be deleted but if you search you can find it.

Here's a copy, below, of the memo from CAJA - you can find it by searching google for "caja issue resolved".

Find the pdf link at the bottom of the above article, online, download it and print it out and take it to CAJA and fix your problem if you were charged the extra $.

"GM-0042-15
GF-10.619

Señores (as)
Directora Institucional de Contralorías de Servicios
Director de Red de Servicios de Salud
Directores de Hospitales Nacionales
Directores (as) de Hospitales Regionales y Periféricos
Directores (as) Regionales de Red de Servicios de Salud
Directores (as) de Áreas de Salud

Asunto: Aplicación del Manual de Adscripción y Beneficio Familiar a extranjeros
migrantes

Estimados (as) Señores (as):

Mediante circular GM-45.786-14/GF-41.425 del 24 de octubre de 2014, se aprobó el “Manual
de Adscripción y Beneficio Familiar”, con el que se implementan las reformas introducidas por
la Junta Directiva a los artículos del Reglamento del Seguro de Salud, 10°, 12° y 13°,
asociadas con la protección a través del Beneficio Familiar.

Por resolución 2015-0000018 de las catorce horas y cinco minutos del seis de enero del dos
mil quince, la Sala Constitucional dispone que es erróneo interpretar que el numeral 20 del
manual de cita, excluya la posibilidad de dar trámite a una solicitud de otorgamiento de la
protección del Beneficio Familiar a favor de una persona migrante extranjera en condición
regular o en trámite de regularización.

En línea con lo anterior, toda solicitud de estudio para el otorgamiento de la protección del
Beneficio Familiar a una persona extranjera en estado regular o que se encuentra realizando
los trámites tendentes a dicha regulación, y así conste en acto administrativo emitido por la
Dirección General de Migración y Extranjería, deberá recibir el trámite y estudio
correspondiente en idénticas condiciones a las que se dan en relación con aquellas
presentadas en favor de costarricenses.

Concordante con lo anterior, se aclara que a los efectos de los trámites regulados en el
“Manual de Adscripción y Beneficio Familiar” la identificación del migrante extranjero regular
se da con la presentación del DIMEX (Documento de Identificación del Migrante Extranjero),
en tanto que el de aquel que se encuentra en trámite de regularización lo es a través del
Pasaporte ordinario o de la cédula de residencia en buen estado.

Además, se instruye para todos aquellos casos en los que se hubiere denegado el trámite de
estudio para beneficio familiar en razón de la errónea interpretación dada, accionar lo
correspondiente para que los peticionarios sean localizados y se de atención a sus solicitudes.

La disposición aquí emitida es de acatamiento obligatorio e inmediato, compete al Área de
Estadísticas en Salud de la Gerencia Médica garantizar su complimiento e implementación.

Atentamente,
GERENCIA MÉDICA
( original firmado )
Dra. María Eugenia Villalta Bonilla
GERENTE
GERENCIA FINANCIERA
( original firmado )
Lic. Gustavo Picado Chacón
GERENTE"

samramon ViP

1338POSTS

11 years ago

#32

Here's the article in A.M. Costa Rica:
http://www.amcostarica.com/011515.htm#31

cupacoffee Contributor

158POSTS

11 years ago

#33

I understand that Outlier was looking into but where is it mentioned that Outliers resolved the case?

samramon ViP

1338POSTS

11 years ago

#34

cupacoffee wrote:
I understand that Outlier was looking into but where is it mentioned that Outliers resolved the case?

I don't know for sure who resolved the case.
But if you look above where I pointed everyone to, you will see that CAJA issued a memo stating that the charging of spouses was wrong.
I know people who have already taken the memo to CAJA (I doubt you even need to do that now) and fixed the over-charging.

The point is that CAJA itself released the memo.

The article linked to in AM Costa Rica above says, in part,

"The Caja officials said that the situation of expats was considered by the board of directors in October.

They said that to receive coverage an individual must have some form of provable relationship with the principal insurer and not have a personal income.

The person to be covered needs to have lived with the insured for at least three years, the Caja said.

In its statement, the Caja reaffirmed the fact that the Costa Rican Constitution says that foreigners have the same duties and rights as Costa Ricans with the exception of limitations established by the Constitution or laws."

Personally I think ARCR or Outlier or someone will sue Costa Rica CAJA to get the extra money paid for CAJA last year back, for those gringos who paid it.

If not, then it's essentially Costa RIca's government and judicial saying, "We robbed gringos of a bunch of money illegally, but we're not going to give it back!"

Which is ridiculous, even for Costa Rica!

Gr8fulmom Active member

35POSTS

11 years ago

#35

Just wanted to update everyone. It took a few trips to the CAJA to get it sorted out but in the end our family is paying well under $100 per month as investors. When we went to Quepos office they wanted us to pay $400 based on $2500 per month which is incorrect for investors. Later in another office they had the correct form for us to fill out where we listed income at $2000 per month MINUS a bunch of expenses like food electricity property taxes etc. so we pay the rate based on out net income in the country under investor status. We explained our income was money from a job outside of CR and we pay tax in our home country. That's where the $2000 comes from. That's it. We are now paying a reasonable rate per family and it's all done! Pura vida. Buen suerte todos!

cupacoffee Contributor

158POSTS

11 years ago

#36

You did indeed get lucky!
It really does depend on which CAJA/CCSS office you are dealing with...as it is well known that many offices will not allow any 'expenses' to be taken into consideration. I just read of one this past week...

Gr8fulmom Active member

35POSTS

11 years ago

#37

I don't get how they don't allow expenses?! It was part of the standard form. There were spaces preprinted to fill in amounts for food electricity etc. Anyways. I feel like you just have to keep trying until you get to an office where they will talk to you and not just lump investors in with rentistas. The whole process made me every anxious and I'm glad it's over!

samramon ViP

1338POSTS

11 years ago

#38

Gr8fulmom wrote:
Just wanted to update everyone. It took a few trips to the CAJA to get it sorted out but in the end our family is paying well under $100 per month as investors. When we went to Quepos office they wanted us to pay $400 based on $2500 per month which is incorrect for investors. Later in another office they had the correct form for us to fill out where we listed income at $2000 per month MINUS a bunch of expenses like food electricity property taxes etc. so we pay the rate based on out net income in the country under investor status. We explained our income was money from a job outside of CR and we pay tax in our home country. That's where the $2000 comes from. That's it. We are now paying a reasonable rate per family and it's all done! Pura vida. Buen suerte todos!

I thought you HAD to go to the local CAJA. So you do get to choose which one to go to?

Also how does it work that you can fill out a form, they say it's $xxx.00/month and then you just reject it or what? Here in the U.S. for example if you go to a government office and they say the decision is such and such based on the form you fill out, you can't just say "Oh no, I reject that, let me go to another office." ???? So how did you manage to accomplish getting a new application at another office?

The answer might be very helpful to others in a similar predicament.

Gr8fulmom Active member

35POSTS

11 years ago

#39

For rentistas and pensianados its a set rate based on $2509 and $1000? You are supposed to have as monthly income. At the Quepos office they said it was the same for investors a set rate based on $2500 but that is not true. We didn't fill out a form they just told us so we left. You are supposed to go to your local office but there is some degree of flexibility because we were able to explain our situation and get someone at a different office to help us and that where we filled out a form... Hope that helps!