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Hi David:
I truly enjoyed your video. When you talked about medical care, there was no mention of cost. Can you tell me a little bit about that? Can people with pre-existing conditions buy insurance? (not seguro social).Hola, el. I’m glad you found the video useful.
The cash cost for medical care in Costa Rica is *generally* much, much lower than in the U.S. For example, you can have a physical exam done by a U.S. board certified internist, with an ecg, for about c30,000 (+/-$58US). Ours does all the work himself (no nurse or technician) and spends most of an hour with you face-to-face. Saturday, I had an A1c blood test for my diabetes for a little less than $40, and you do not need a physician’s order.
Every medical and dental practicioner I’ve encountered has been patient, thorough and (as far as I can discern) as capable as any I’ve used in the U.S. Even my local pharmacist is a great help for routine things. Many physicians here have trained in the U.S., Canada, Europe or (in the case of my gastroenterologist) Japan.
Most drugs are available over-the-counter without a physician’s prescription. Many are much cheaper, but, for example, the two main drugs I take to control my diabetes and cholesterol cost about $35 per month each. Given everything I take, it’s better for me to use my U.S. mail-in service and have the meds shipped in.
If you’re over 55, enrollment in the CAJA national medical system costs $40 per month for a couple. It’s a heckuva deal. When I injured my knee last year, I went to our local CAJA hospital where I was immdeiately seen in the Emergency Department, had two x-rays, saw an orthopedic surgeon, and had a cast applied. I was in and out in under two hours. Since we were not enrolled in the system at that time, the whole thing cost c70,000 (less than $140US) and I thought the care was just fine. In general, however, the CAJA system seems to have a lot in common with the lesser HMOs in the U.S. And they do not provide the diabetes meds I take.
The private insurance market will likely change under CAFTA. For now, INS has the monopoly on health insurance. They generally will NOT cover pre-existing conditions, and if you have likely complications from a pre-existing condition, they will probably surcharge you. For example, since diabetics tend to die of heart disease, I’m charged a 60% surcharge on my premium even though I have no history of heart disease and my diabetes is in excellent control. Fortunately, the surcharge applies only to my portion of the premium and not to my wife’s.
There are companies which offer health care insurance internationally. They, too, tend to exclude pre-existing conditions, and if they deny coverage it may be impossible to pursue them legally. And you could be dropped at any time. Seems like a shot in the dark to me.
Does any of this help?
Thank you so much for this information. It was more than I expected and very useful.
My wife and I both have pre-existing conditions, so we have been debating whether to move to C.R. now or until we qualify for Medicare. In the event of a major illness we could always return here for treament. But the medical care there sounds good and not at all expensive.Thank you again for taking the time to answer.
I’m happy if that helped. Just two things . . .
You mention Medicare. Do you realize that there are no medical providers here who are authorized to participate in the U.S. Medicare program? Your Medicare coverage won’t do you any good here in Costa Rica.
It’s important, too, to bear in mind that while medical care here, on a cash basis, is less expensive than in the U.S., still treatment of a significant problem can be very costly.
David: You made a very good point about a serious illness. That is why we are so scare to make the move, in spite of all the beauty that this country offers.
I am curious to find out how most american retirees living in Costa Rica handle this situation? Do they majority of them plan to live there for as long as their health allows and then move back?
Bearing in mind that you must be a legal resident to qualify, there appears not to be much about the CAJA system not to like when it comes to major health events. I’ve known several folks now who have had life-changing health problems and who got very good care in the CAJA system. Those have included treatment of stomach cancer and an abdominal aortic aneurism, a major heart attack, a circulatory problem in the leg which has required two amputations, and a broken ankle that required surgery. All those folks felt that their care was totally acceptable. And cheap.
Where the CAJA seems to fall down is on outpatient care and sophisticated diagnostic work. Those are things which one might pay cash for.
And there’s still INS. Remember that you can have a policy under INS and also be enrolled in the CAJA, and you need not be a resident to buy an INS policy.
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