| Costa Rica's health care system is available to retirees
(pensionados and rentistas) and other foreign
residents. Residents may join the Caja Costarricense de
Seguro Social (Costa Rican Social Security System) and
enjoy the same inexpensive medical coverage as most Costa
Ricans do. Most foreigners do not enroll in this system because
of the long waits for medical appointments, some medications
and other delays. However, despite being overburdened, the
emergency care provided is very good. There are also clinics
all over the country. At a low cost of no more than $60 monthly,
the Caja is a good deal for foreigners.
The cost to affiliate directly is about 13 percent of your
monthly income by law; however the ARCR (http://www.arcr.net)
has a legal contract with the Caja to affiliate at
a very reasonable price.
As we just stated, according to the law you must pay 11 to
13 percent of your income to the Caja for voluntary
medical insurance. We know of some foreigners who try to get
around this by lying about their income and paying the minimum
of about $25 monthly. If they are legal residents, the government
will know they have at least an income of $600 per month and
should be paying about $70 monthly. If they are caught underpaying,
they can be fined and ordered to pay the difference in what
was not paid in the first place. You shouldn't try to cut
corners.
Most foreigners and retirees opt for the medical insurance
offered by the government's insurance company the National
Insurance Institute or INS. Everyone is eligible to apply,
including permanent residents, pensionados and even
tourists. Elderly people have to submit to a physical before
they can be insured. The medical policy covers expenses resulting
from illness, accidents, hospitalization, office visits, lab
work, medicines and medical costs in foreign countries. However,
if you incur medical expenses abroad, INS will pay only the
amount equivalent to the same treatment in Costa Rica and
you have to pay the difference.
When you purchase a policy, INS will supply you with an identification
card and a booklet that lists the names of affiliated groups
such as hospitals, doctors, labs and pharmacies. Most surgical
procedures are covered 100 percent. You pay a small deductible
for office visits, labs, medicines and treatments. If you
seek medical services not affiliated with INS, you have to
pay up front. You then submit a claim to INS and will be reimbursed
in a few weeks.
Depending on age and sex, the annual cost of this insurance
is about $800 for a man 50 to 69. For example, rates for a
man 18-39 year s old run about $250 per year; $1,800 for a
70-year old man ; and women of all ages pay an average annual
rate of about $1,500. Women of childbearing age pay slightly
more than men. There is a discount if more than one person
is insured on the same policy. It is easy to enroll an entire
family for a low monthly rate. If you belong to a group of
15 or more people such as the Association of Residents
(ARCR) or the American Legion you can obtain an approximately
a five percent discount.
There is a ceiling of around $17,000 per individual. Since
medical costs are so low in Costa Rica, this policy is more
than enough to take care of your medical needs. Retirees and
other residents need not worry about lacking adequate medical
coverage in Costa Rica. For information, go to the ARCR or
contact them at: (Tel: 233-8068, Fax: 011-(506) 222-7862)
or see http://www.arcr.net. You can reach the National Insurance
Institute at 223-5800.
INS now offers a new international insurance policy that
covers your needs in Costa Rica and the rest of the world.
This new medical policy covers medical expenses resulting
from accident or sickness. Here are some of the items covered:
hospitalization and ambulance expenses, maternity, prosthesis,
organ transplants, air evacuation, repatriation of remains,
funeral costs and a yearly check-up and eye test. The rates
are high but the coverage is very complete.
Mixed Medicine
This method of combining both public and private
health care can work in several ways. Some Costa Ricans and
many foreigners use the Caja as a type of back up insurance
for extra protection. They utilize a private doctor for minor
ailments and the Caja for major problems, while others
use the Caja for certain tests and expensive medicines
and minor illnesses. Another way to do it is to use a private
physician for problems that require a long wait through the
Caja. The waits for some tests and procedures can take
months, so people with cancer and other serious problems often
go to a private lab to get faster test results.
Many doctors who have a private practice and also work in
the public system will operate on their patients in a public
hospital to reduce costs.
Be careful of so called biombo. A biombo is
a medical practice that has been used from time to time by
some unscrupulous individuals in the medical profession. For
example, a couple of medical professionals employed by the
Caja were just arrested for taking samples of blood
at their own private laboratory and then using equipment at
a public hospital to do the analysis.
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