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I have not found this mentioned previously, so here goes: my husband, daughter and myself are moving permanently to Costa Rica, Atenas December 4th; we all have medications filled by Medco by mail, and am wondering:
1. Are the same medications are available in Costa Rica, hopefully cheaper (and how do I find out?)
2. Is the mail reliable when it comes to prescriptions–we have a mail box in Atenas, but have heard some really diverse opinions on how well the system works for delivery time!!!!! Pura Vida!
Most, but not all, medications that are available in the U.S. are available in Costa Rica. Some of the newer ones take a while to be approved by the Ministry of Health. Of those that are available, not all are available from the CAJA. My experience is that the same meds you get in the U.S. are generally cheaper here, but that doesn’t necessarily mean “cheap”.
To find out what’s available here, go to your local Atenas farmacia and ask. When you compare costs, consider your co-pays, deductibles, mailing costs, etc in the comparison. Buying locally may be cheaper . . or maybe not.
Question: Does Medco ship internationally? I’d be surprised.
We use Aerocasillas’ transshipping service for mail and packages from the U.S. They have been reliable, if not instant, and there is a cost based mostly upon weight of the item they bring in. They give you a street address and a post office box number in Doral and Miami, Florida respectively to which American mailers and shippers can address your stuff. With that, you can comfortably order things like meds from Medco and expect them to arrive in reasonable time. You can also shop on the Internet and use the Aerocasillas addresses for shipping.
Apparently, Customs will pass just about anything through without delay IF the package weighs less than one kilogram. We’ve learned this the hard way. In April, I ordered a bunch of meds from Express Scripts which were sent to our Aerocasillas address. Because the package weighed more than a kilo, it was held up first by Customs and then by the Ministry of Health. We had to get a Costa Rican physician’s prescription to get the package released. Prior and subsequent smaller shipments have come through without delay. So the moral is: Order your meds from Medco one at a time so they’re shipped separately.
Edited on Oct 07, 2009 08:02
I have exactly the same issue. Planning to move to CR if I can work out medical delivery from the US and specifically Medco. You are correct, Medco will only deliver to a US addresgs, I have asked them and they confirmed this. Secondly, I understand that shipping meds to a PO Box in the US and having them forward it to CR is risky in that CR Customs might hold it up unless you get prior approval from Ministry of health to import for personal use.
Availability…my wife has two chronic diseases and takes 11 prescription meds. I am retired and have godo prescription coverage that makes meds cheap to me via Medco for any that are not a one time prescription. All but 10 of the 11 my wife takes are available in CR. That one that was not available was a narotic for mirgrains which she just takes as needed.
One medicine my wife takes by shot every other week is the key issue for me. It has to be kept chilled so is shipped on dry ice. That works to the US but not to CR even if I can work the US address issue. This med, humira is a new drug and key to her treatment. The cost in CR was $1000/shot so $2k per mos. With my insurance I get it for less than 10% that amount due to my employer coverage. So I must find a way to get meds to CR.
My plan is to ship to a US address a 3 mos supply, then make trips to the US every 90 days or so to pick them up, especially Humira adn bring them with me to CR. The open question I have is can I bring meds in for my wife’s consumption and could a sister in law bring them in fo her when she comes to visit us? I think so with a letter from the Doctor about the drug…but not certain yet.
Let me know if you have added questions or comments.
John, if you keep the quantities small, that is, order one or two prescriptions per shipment, and have them shipped to a U.S. Post Office Box such as the one that Aerocasillas would assign to you, I really don’t think you’ll have any problems. I’ve been doing this for four years and the only time I’ve hit a snag was when I had all my meds and glucometer test strips shipped in a single order. Then there was a bureaucratic hassle, but we got through it. Based upon my experience, I see no reason to consider this to be risky.
It would also be much less risky to have Aerocasillas shepherd your meds through Costa Rican Customs than trying to do it yourself. And it will be a lot less hassle for you.
My recommendation would be to arrive here with the largest quantity of meds you can get from Medco and then immediately order refills — one at a time. That way, you’ll have a head start if there is a problem.
If you can get the Humira sent to your sister-in-law, might she then reship it to Costa Rica via UPS overnight? When we did that with some documents four years ago, it cost about $50US, but the docs were here the next day. You’d have to check and see if UPS will accept something packed in dry ice, however.
I think you’re pretty safe in having your sister-in-law bring meds in or doing so yourself. Generally, Customs won’t bother you over such things. I wonder, however, if (just to be safe) you could get a physician in the U.S. to prescribe those meds for you or your sister-in-law. Of course, then there’s the matter of the labels on the bottles . . .
I just checked with Medco, and they said we would have to write a very detailed letter requesting a 12 month supply of all the meds, including an explanation of where we are moving and why! This has to be reviewed by their appeals board, then if approved the dr faxes in to them a request for a 365 day supply! Seems like a lot of trouble but I’ll give that a try! I’m also going to check into Aerocasillas, too, for our mail from the US–thanks for the info on that!
Why not go to your local(in CR) Farmacia and find out what they can provide for you and the cost. When we moved here that is what we did and it has worked out just fine. Most of the pharmacy’s have a doctor on premise.
Diane, I’m confused. Rather than going through all that hassle with Medco and their appeals board, why not just order a ninety-day supply of your meds as you do today but have them sent to Aerocasillas’ (or one of their competitors, if you prefer) address in Miami? Can you not order refills online as you need them?
By the way, I know an American-licensed physician here who will write you prescriptions for your maintenance meds. Express Scripts, at least, accepts them without question . . . and sends my meds to me via Aerocasillas.
I went to the site for Aerocasillas, but the closest delivery was in Grecia, and maybe I don’t understand how it works, but it seemed to be a ways to go to pick up our “stuff”–but then maybe I don’t understand the process (probably!), and a bit expensive–I haven’t looked up a kilogram (I’m only familiar with pounds and ounces at this point), and couldn’t figure out how much I would have to pay for letters/bills arriving from the US; maybe I will just do as you propose: arrive with a 90 day supply of meds, and during that time, I should be able to figure out what is available in Atenas, and the cost, and figure out the Aerocasillas process– My husband is diabetic, so needs all that stuff that comes with keeping his insulin in check!! thank you both for the added insight!!
Diane, a kilogram equals 2.2 pounds.
We pay about $1.50 to have Aerocasillas forward one (or sometimes more than one) letter to us from Miami. We’ve had all our paper mail stopped. Almost everything is available as an electronic statement now.
Grecia is about half an hour from Atenas via the “back way” which is also the scenic route. Aerocasillas will send you an e-mail when you have something to retrieve or you can call the Grecia office. The young man who works there speaks passable English and is very helpful.
I’m diabetic too, and I get my meds and test strips from Express Scripts in the U.S. What you have to do is compare the cost of your co-pays and deductibles, the cost of shipping, if Medco charges you, the cost of Aerocasillas’ services, and whatever Customs charges you for import duty and sales tax against the retail cost of those same meds and supplies here.
What I’ve learned is that there isn’t a reliable supply of test strips for a glucometer that does alternate site (arm or leg) testing, and my meter isn’t sold here at all. So the strips are going to come from the U.S. one way or another. And I’m now reconsidering whether it’s worth it to me to keep ordering from Express Scripts or to buy locally. One problem is that the CAJA doesn’t provide the two really expensive meds I use, Vytorin and Januvia. The cheap stuff they’ve got.
I am in the same boat with medco Diane. I also am looking in Atenas, where I understand you are. If we both got mail boxes at the same place, we could when needed pick up packages from both mailboxes.
Thanks for the comments here all, most helpful.
I understand bringing meds in, if you check it the odds are it could come in with no issue. I do not recall ever having my checked luggage examined in Costa Rica…any have that done…is it randor as in the Us and for cause too? I do not recall declaring meds coming in for my/my wife’s personal use on the forms. Does that seem right even if I bring the meds for my wife or to CR?
I contacted aerocasillas and they advised me that they do not ship meds to CR? Is there some process you used to have this done for you or just ship packages to CR with no issue other than that one time you mentioned when all were shipped at once?
Perhaps my best option would be to have meds shipped to a family members address in the US then have them package them one bottle of pills at a time to me in CR?
I may need to recheck the economics of less expense meds/pills. Having some of them filled in CR rather than the US might be cheaper despite my lack of insurance subsidy in CR. I know most of the meds my wife takes are available in CR. Only one, a migraine medicine that was narotic based that could not be obtained in CR. Do you split your source of meds for economic reason as well or does it almost always make sense to get them in the US and ship them to CR?
Aerocasillas has never been the stumbling block. It’s been Customs and the Ministry of Health. It may be Aerocasillas’ POLICY not to transship meds, but it works for me. My meds come in labeled “medication” or somesuch, so it’s not like Aerocasillas doesn’t know what they’re handling.
I cannot see how having your meds shipped to a relative to reship them would be an advantage. Why not instead just order one prescription or refill at a time and have them sent directly to the Aerocasillas address?
Since last October, when our co-pays doubled and in some cases quadrupled, I have been reconsidering just buying locally here in Costa Rica. For some meds, the CAJA is a perfectly good alternative. For the more expensive ones, which the CAJA does not provide, it still may be cheaper and easier to buy locally than to pay the U.S.-licensed doctor here to prescribe them, send in the scripts, pay the co-pays, and then pay Aerocasillas and the taxes.
My diabetes glucometer test strips are not available at all in Costa Rica, so they will continue to come from the U.S.
John, is the narcotic medication your wife takes really not available here, or does it require a Costa Rican physician’s prescription to purchase it? Generally, narcotics do require a doctor’s prescription here but that doesn’t mean they’re not available.
I think the pharmcist told me it was not available in CR. She mentioned I would need a prescription for narcotics but this one wasnt there. She speculated it was due to it being a narcotic based med. Would I still be able to bring it into CR if it is not available there, either in personal luggage or mailing it?
My pills sometimes get bunched together for mailing by Medco, so the benefit of the relative in the middle would be to break them down to one pill bottle per shipment to me in CR.
Have you heard of someone having medicine brought into CR in checked luggage by a spouse without issue?
John, as I’ve suggested before, if you unbundle your medication orders from Medco by ordering them separately, maybe a day or two apart, they’ll be shipped separately and you’ll be much less likely to get tangled up in the bureaucracy.
I wonder if an alternative medication for your wife’s migraines, one that is available here, might work as well . . . just wondering.
Customs isn’t the tightest operation you’ve seen. If you or someone else brings in a modest amount of medication, I’ll bet you’ll have no problem whatsoever. If I were bringing in meds for myself or someone else, I’d put them in my pocket and just walk on through the Customs screening.
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