CAJA Costs

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  • #161573
    Imxploring
    Participant

    [quote=”sweikert925″]It seems to me that even at 13% of your retirement check, the ability to join CAJA is a fantastic bargain. The care by all accounts is excellent and it covers everything. The availability of joining the Costa Rican healthcare system is one of the major reasons I have decided to move to CR. My only fear is that they will remove the ability for expats to join it entirely in the coming years.

    For those who paid into Medicare for 40 or 50 years and then leave the US just as you reach the age when you can start benefiting from it is certainly a bit galling, but remember that Medicare doesn’t cover all your costs – which is why the healthcare insurance company I work for makes a tidy profit selling Medicare Advantage policies to the over 65 market.

    It needs to be pointed out that for Costa Ricans the cost of participating in CAJA is nearly 36% – 9% deducted from their paychecks and another 27% paid by their employers. I wonder what they would feel about gringos griping about paying only about 1/3 of that on their much larger incomes and still have full benefits almost as soon as they take up residence in CR.

    Imagine what Americans would say if the US government offered Costa Rican retirees taking up residence in the US full benefits from Medicare for less than what they were required to pay into it their whole lives.[/quote]

    Good points but there are a few issues you need to consider. First off many retirees with sizable retirement income will be forced into a public healthcare program in CR that will cost more and provide less than if they took that same monthly charge and purchased private coverage or went on a pay as you go basis for medical care. The argument that insurance is for the “just in case” major expense of catastrophic illness really doesn’t fit here since, as good as the medical in CR CAN be… it’s not always nor is it anywhere near that provided in the US. Most US expats when confronted with a serious condition such as cancer will return to the US for care.

    If you recall recent history we’ve had some of the wealthiest and important people in the world (none US citizens) come to the US for treatment of serious conditions.

    So what CR has in effect is a “stop loss” when it comes to the medical care provided to expats forced into CAJA. Sure they’ll be providing basic medical care and maintenance, they’re quite good at that and the cost is minimal as anyone that has needed such care and paid cash can confirm. However, when more serious treatment is required where the availabilty and cost become a concern, expats will return to the US thus relieving CR of the obligation or cost of such care. Not a bad deal for CR…. not so much for those forced into CAJA and made to pay more in a short period than many Ticos have in a lifetime.

    The cost and level of care for a retiree getting a sizable pension is therefore not very reasonable when being FORCED into a plan as a requirement of obtaining residency in CR. The issue of also being forced into a plan in the US should one not meet the exemptions for remaining outside the US make it a double edged sword.

    I’m still awaiting a clear confirmed answer on how the other two methods of obtaining residency are billed for their participation in CAJA.

    #161574
    costaricafinca
    Participant

    [quote=”sweikert925″] The care by all accounts is excellent and it covers everything. The availability of joining the Costa Rican healthcare system is one of the major reasons I have decided to move to CR. My only fear is that they will remove the ability for expats to join it entirely in the coming years.
    [/quote]

    There are [b]many[/b][i][/i] who will dispute this statement. In an emergency, the CAJA will step in, but if you are not shedding blood on the floor, you may have to wait a few years to see a specialist. I have utilized the emergency services and it was good…but the follow up care, was a whole different matter. A Costa Rican friend last week was told that he had to wait approx 5 years for a hernia operation!!!

    [b]And they do not ‘cover everything'[/b] Many medications must be purchased ‘over the counter’ at a local pharmacy or you may given a generic version. You will still need to pay for eyeglasses and dental work.
    Please do not try to tell us, who actually use this service that everything is perfect. It isn’t. Just read the local online papers and see how many ‘tests’ are still waiting to be processed a few years after the fact
    Most of the ex-pats choose to use private facilities to be assured of a quick diagnosis and treatment. So if you think that CAJA will be your answer, think again.

    #161575
    VictoriaLST
    Member

    We have a friend on crutches – CAJA says two years before they do her hip replacement. Just another reason why socialized medicine, whether it’s CAJA or Obamacare, is a bad idea.

    #161576
    ratus
    Member

    Is the CAJA rate based on gross income? Because my wife’s pension is $4100 a month gross, and then the CAJA rate will rise to $520 a month…As a Canadian, that’s a hard pill to swallow..pun intended 😯

    Another option available to us, is residency as an investor, our purchase price on our home exceeds the 200k minimum…does anyone know how CAJA will decide the rate if you get residency by the inversionista route. Gracias.

    #161577
    costaricafinca
    Participant

    Unless you are both going to apply separately, only one pension of at least $1000 per month is required. Sometimes it is advantageous to both apply, in case of the death of the primary applicant, the remaining spouse will be required to apply again, if they are still ‘temporary residents’.
    As some of us mentioned before applying for Investor status is hit or miss, and it usually takes even longer.
    Can’t help with the what the monthly fee going that route may be. Contact your chosen lawyer or [url=www.arcr.net]ARCR[/url]

    #161578
    Imxploring
    Participant

    [quote=”costaricafinca”][quote=”sweikert925″] The care by all accounts is excellent and it covers everything. The availability of joining the Costa Rican healthcare system is one of the major reasons I have decided to move to CR. My only fear is that they will remove the ability for expats to join it entirely in the coming years.
    [/quote]

    There are [b]many[/b][i][/i] who will dispute this statement. In an emergency, the CAJA will step in, but if you are not shedding blood on the floor, you may have to wait a few years to see a specialist. I have utilized the emergency services and it was good…but the follow up care, was a whole different matter. A Costa Rican friend last week was told that he had to wait approx 5 years for a hernia operation!!!

    [b]And they do not ‘cover everything'[/b] Many medications must be purchased ‘over the counter’ at a local pharmacy or you may given a generic version. You will still need to pay for eyeglasses and dental work.
    Please do not try to tell us, who actually use this service that everything is perfect. It isn’t. Just read the local online papers and see how many ‘tests’ are still waiting to be processed a few years after the fact
    Most of the ex-pats choose to use private facilities to be assured of a quick diagnosis and treatment. So if you think that CAJA will be your answer, think again.[/quote]y

    For someone with a nice pension I’m thinking that private insurance in CR would be a better deal financially and care wise. The whole idea of the government in CR forcing folks into CAJA as a requirement of residency has more to do with money than providing care. As I stated before they are well aware that should an expat require serious care they will return to the US or go private in one of the many excellent hospitals in CR thus taking CAJA off the hook for the big care costs!

    The question then becomes why would someone with a $4k -$5k per month pension bother with applying for residency?

    Once again…. CR shooting themselves in the foot! And for those that feel it’s a reasonable price consider this…. if CAJA is based on your GROSS pension and they require 13%………… you then have Uncle Sam picking your pocket next based on gross…. then the 13% sales tax in CR on what you spend…. so before you get a chance to spend a dime of your hard earned pension on living… you’ve lost about 35% of your gross income. So don’t be so quick to give up that CAJA deduction which might not provide the service or peace of mind you think it does!

    If CAJA was a reasonable flat fee based insurance plan offered to expats it would be much more attractive since I would consider it only a basic care plan. I’m certainly not looking to give up 13% of my income for it! The ROI is a loser not many will ever benefit from.

    #161579
    costaricafinca
    Participant

    We have been living here for 13 years and so our monthly payments are less than that, and is based on the requirements of that period, but [i]Pensionados[/i] who more recently have been based on the minimum $120 are approx.$120 and [i]Rentistas[/i] with $2500 is approx $250

    #161580
    costaricafinca
    Participant

    What you actually said was [u]’…it was excellent’.[/u] It isn’t
    I am not going to get into a heated discussion with someone that has [b]never[/b][i][/i] been here, [b]never used[/b] CAJA but can find information, any information, on the net which support his answer.

    #161581
    Imxploring
    Participant

    [quote=”sweikert925″][quote=”costaricafinca”]
    Please do not try to tell us, who actually use this service that everything is perfect. It isn’t. Just read the local online papers and see how many ‘tests’ are still waiting to be processed a few years after the fact
    [/quote]

    That’s funny, I don’t recall saying “everything is perfect”. Please refresh my memory about when I said that.

    What I actually said was that most accounts I’ve read from US expats who live in CR indicate they are reasonably happy with the care, which your comment seems to reinforce. If the worst thing that can be said about a healthcare system is that you may have to wait for non-critical care, well that’s not a very severe criticism.

    If there are 2 systems and in one everyone gets cared for but some care is delayed, and in the other there are fewer delays but some get left with no care, then I think the first one makes more sense. It’s the one I think is fairer anyway. Others are free to disagree.[/quote]

    I’ll stick with my statement that MOST expats if confronted with a life threatening illness will return to the US for care. That’s not a slap at the healthcare system in CR. As I said they are very good at providing basic medical care and maintenance treatment. However, their system for providing care for serious conditions is neither timely or robust enough to risk one’s life on.

    I base that statememt on my own experience with 4 expats over the last 8 years that have been in that situation. That includes one that required treatment for an alcohol addiction. All were quite happy with the medical care in CR. But when it came to care for conditions that were serious enough that it became live or die…. they went back to the US for care.

    It might be an interesting poll… how many expats that are using CAJA for their medical care in CR would risk their lives with CAJA if confronted with a life threatening illness rather than return to the US for care? I’m guessing very few. Once again not a dig on CAJA, they do the best they can and are good for the basics which thankfully is what most of us need.

    As to cost. Even the quotes (Cigna) you provided were better than the fee CAJA will be hitting you with if they charge you 13% on a good pension. Keep in mind CAJA provides public health services and is not an insurance based plan. And as I have said, a BASIC plan in my opinion. So you have to be affiliated (member) of the system. The quotes, if providing insurance coverage for care provided in the private medical system in CR, provide much better bang for the buck.

    We would have to ask Scott for help from one of his contacts that might offer some clue as to the availabilty and cost of CR based healthcare insurance which I’m guessing would be less expensive.

    As others have said from their own experiences, CAJA is not the answer to your problems, nor is a wonderful deal if you are being forced to pay $500/month as a requirement of your residency.

    #161582
    davidd
    Member

    sweikert925

    your continued rants on all things costa rica is leading me to believe that you may actually be experiencing a case of

    [b]analysis paralysis [/b][size=][/size]

    you probably already have more information than you need to take decisive action but what you are doing is deploying Diminishing Returns.

    it would be the same as if you were polishing your car and you focuses on the hood and you kept polishing and even though you already achieved the desired effect you kept on polishing the same area

    over and over and over again.

    At some point your efforts are greatly reduced in relation to the effect.

    everyone’s personal threshold of experience is different and what I or someone else may find acceptable or not may or not be acceptable to you.

    If you were truly a student…. that wanted to learn about if Costa Rica is the right choice.. you would be constantly asking questions from people that live here and thier perosnal views based on actually living here….

    instead of trying to put forth your views on what you feel is right because you read this on the internet.

    Ask questions and come to your own conclusions as best as you can.

    does this make any sense to anyone besides myself???

    I would bet you a plum nickel what your political views are but will not soil this thread. :D:D:D

    sweikert925

    here is a FACT!!!! ( and if anyone else disagree’s please add to this as I am open to listen to people living here.)

    There are especially here in costa rica;

    [size=200]1.) the way things should be.

    2.) The way things are ( in the real world regarding execution of the way things should be) :P:P

    3.) and the balance between both as we move thru this thing we call life 🙂
    [/size][b][/b]
    it’s like the example of the brochures of living in costa rica.. as opposed to the actual living in costa rica

    add to this mix your own personality thresholds and we have different experiences all the way around.

    anyway

    saludos to everyone because things could be worse.. imagine living in Chicago

    http://articles.chicagotribune.com/2013-06-16/news/chi-chicago-crime-shooting-gun-violence-marquette-park_1_lowest-homicide-totals-weekend-west-north-avenue

    [quote=”sweikert925″][quote=”imxploring”]
    As to cost. Even the quotes (Cigna) you provided were better than the fee CAJA will be hitting you with if they charge you 13% on a good pension.
    [/quote]
    At $585.75/month, which is what a Cigna plan would cost with a $0 deductible, you would only come out ahead on cost if your pension on which CAJA is calculated was over $4,505/month or $54,000/year. How many people do you know that have that kind of pension?

    I also need to remind you that the Cigna figures I quoted above were for a 65 year old man. Cigna adjusts the premiums as you get older so that by the time you’re 70, the premium would be $613.77/month if you took the $1000 deductible option and $1,132.46/month(!) for the $0 deductible option. For that person to come out ahead on cost his or her pension would have to be $8,711/month or $104,532/year.

    [quote=”imxploring”]
    The quotes, if providing insurance coverage for care provided in the private medical system in CR, provide much better bang for the buck.[/quote]

    I will readily concede that paying for private care in CR may result in better quality but if you can’t afford it, it doesn’t make a lick of difference how good the care is. You’ll never get to experience any of it.

    Maybe I’m just not as demanding as the average person but for me as long as the care I got was adequate that’s fine, I don’t need Rolls Royce care as long as Chevy care did the trick.[/quote]

    #161583
    Imxploring
    Participant

    [quote=”sweikert925″][quote=”imxploring”]
    As to cost. Even the quotes (Cigna) you provided were better than the fee CAJA will be hitting you with if they charge you 13% on a good pension.
    [/quote]
    At $585.75/month, which is what a Cigna plan would cost with a $0 deductible, you would only come out ahead on cost if your pension on which CAJA is calculated was over $4,505/month or $54,000/year. How many people do you know that have that kind of pension? You may call that a good pension, but I call it a fantastic pension.

    I also need to remind you that the Cigna figures I quoted above were for a 65 year old man. Cigna adjusts the premiums as you get older so that by the time you’re 70, the premium would be $613.77/month if you took the $1000 deductible option and $1,132.46/month(!) for the $0 deductible option. For that person to come out ahead on cost his or her pension would have to be $8,711/month or $104,532/year.

    [quote=”imxploring”]
    The quotes, if providing insurance coverage for care dprovided in the private medical system in CR, provide much better bang for the buck.[/quote]

    I will readily concede that paying for private care in CR may result in better quality but if you can’t afford it, it doesn’t make a lick of difference how good the care is. You’ll never get to experience any of it.

    Maybe I’m just not as demanding as the average person but for me as long as the care I got was adequate that’s fine, I don’t need Rolls Royce care as long as Chevy care did the trick.[/quote]

    Unfortunately I know quite a few people with rather great pensions (in your opinion) that are in no rush to give up 13% (if that is in fact the number CR is now requiring for CAJA and residency) of their gross income for a plan they will most likely not use. Myself included. CAJA cannot even be compared to private care in CR nor is it anywhere near the care one can get in the US for the treatment of serious illness.

    Comparing the permiums for insurance issued by a US based company against an arbitrarily imposed percentage of income for a public health service does both an injustice! It’s like comparing pineapples and bananas! LOL

    For someone meeting the minimum income requirements for residency and paying $130/month perhaps it’s a good deal for basic medical care. However, even someone in that situation most likely would avail themselves of better care in the private sector in CR or return home to the US if confronted with a serious health issue requiring timely and comprehensive treatment. So CAJA is off the hook for the serious care for most expats forced into the system in my opinion.

    After all the information you have obtained about CAJA can you honestly tell us that if you found out you had a life threatening brain tumor five years after you’d relocated to CR, obtained your residency, and were using CAJA for your medical care that you wouldn’t return to the US for treatment?

    If we are going to compare private health insurance premiums to the CAJA system then why should participation in CAJA be based on income rather than a fix premium? And once again, private health insurance would provide MUCH better availability of care than CAJA ever could.

    Perhaps if the premium for CAJA was a fix amount or, as a requirement of residency, participation in a private health plan was acceptable it would be a good deal. As it is now, it’s not.

    So CR is really ignoring the fact that they may very well be shutting themselves out of attracting the higher income retiree that they should be courting! Investment and jobs going elsewhere. Not good business nor the message they should be sending as the world sees an aging population seeking a warm place to retire!

    #161584
    Imxploring
    Participant

    [quote=”sweikert925″][quote=”imxploring”]
    Unfortunately I know quite a few people with rather great pensions (in your opinion) that are in no rush to give up 13% (if that is in fact the number CR is now requiring for CAJA and residency) of their gross income for a plan they will most likely not use. Myself included. CAJA cannot even be compared to private care in CR nor is it anywhere near the care one can get in the US for the treatment of serious illness.
    [/quote]

    If someone having THAT high a pension is really that bothered by paying 13% to CAJA then I would wonder why they would even consider retiring to CR. There are other places where the climate is just as nice and there is no socialized medicine.

    [quote=”imxploring”]
    Comparing the premiums for insurance issued by a US based company against an arbitrarily imposed percentage of income for a public health service does both an injustice! It’s like comparing pineapples and bananas! LOL
    [/quote]

    No, it’s not. While Cigna is a US insurer, the quote is specifically for [b]private care administered in CR[/b], not for care in the US. If the quote was for US care, it would be MUCH higher.

    [quote=”imxploring”]
    After all the information you have obtained about CAJA can you honestly tell us that if you found out you had a life threatening brain tumor five years after you’d relocated to CR, obtained your residency, and were using CAJA for your medical care that you wouldn’t return to the US for treatment?
    [/quote]

    If the situation arose between the time I first retired at age 62 and the time I turned 65, then yes, absolutely, because I would have no other option. Even at the lower private cost of medical care in CR, I would probably not be able to afford to pay out of pocket for whatever brain tumor treatment might cost. After I turn 65 I do have the option of using Medicare in the US but the answer to your question is still probably yes, because even though the care might be mostly paid for by them, it wouldn’t be fully paid for and it’s unlikely I would have the money to pay whatever the difference is. Why should I automatically assume that whetever doctors treat my tumor in the US are better than any that might treat me in CR?

    Your problem seems to be with medical care in Costa Rica generally rather than care available through CAJA because you frame the question as one of CR treatment vs US treatment. You automatically assume that US care will in all cases be better than care in CR. That may be true – but it may not.

    [quote=”imxploring”]
    If we are going to compare private health insurance premiums to the CAJA system then why should participation in CAJA be based on income rather than a fix premium? [/quote]

    As with the question I was asked recently about Obamacare, I’ll have to direct you to someone else. I had no input into how that decision was made nor any insight into why. But I advise against asking the US embassy staff – you’re likely to get “Idunno” LOL[/quote]

    There are a number of advantages to CR that one by one seem to be disappearing. Luckily some of us will not need or be required to seek residency. The ability to spend part of your retirement in CR is still attractive, however, for folks that must “put all their eggs in one basket” and relocate to CR completely the advantages and costs are not as attractive as they once were. Our longtime retirees and those that have watched over a period of time as the incentives and benefits have slowly eroded can confirm this I’m sure! Really a shame the folks in charge in CR don’t see that!

    As to the quality and availability of medical care comparing CR and the US…. that was a rhetorical question I hope! LOL

    #161585
    Imxploring
    Participant

    [quote=”sweikert925″][quote=”imxploring”]
    There are a number of advantages to CR that one by one seem to be disappearing. Luckily some of us will not need or be required to seek residency. The ability to spend part of your retirement in CR is still attractive, however, for folks that must “put all their eggs in one basket” and relocate to CR completely the advantages and costs are not as attractive as they once were. Our longtime retirees and those that have watched over a period of time as the incentives and benefits have slowly eroded can confirm this I’m sure! Really a shame the folks in charge in CR don’t see that!
    [/quote]

    I suspect that the government of CR still values having expatriates relocate to CR or they wouldn’f offer such generous inducments to do so. The fact that they aren’t as generous as they once were is certainly troubling both the current resident gringos and prospective ones such as myself. But the government of CR can’t be expected to cater to foreign nationals wanting to relocate, their priority should (and no doubt is) what is best for Costa Ricans. I think they’re a better judge of what that is than you or I.

    It could be that they offered very generous inducements initially to get noticed as a retirement haven and now that they are they feel they can cut back a bit on the inducements and still get people to relocate there. Anyone who has studied marketing knows what I’m talking about. When you introduce a new product keep the price as low as possible (maybe even below production costs if you can) and then raise the price as your market share increases.

    But maybe not. Maybe they are killing the goose that lays the golden eggs and aren’t even aware they’re doing it. Who’s to say.[/quote]

    Two issues with your statement….

    What do you consider the “generous inducements” these days?

    And

    With marketing you don’t raise your prices or lessen the attractiveness of your product just when the BULK of your target market (in this case folks entering retirement, baby boomers) are coming into the market. That’s when you grab market share.

    If CR is following your path they jumped the gun a bit on monetizing the retirement bubble. The information age makes it too easy to “shop” for the best price and value these days in real-time. Looking at many of the sources for retirement information and advice they often skip CR as a place to consider. Some I agree with on the issues raised, others I do not.

    We each must weigh all the available information and see how it dovetails with our needs, expectations, and resources.

    #161586
    Imxploring
    Participant

    [quote=”sweikert925″][quote=”imxploring”]
    What do you consider the “generous inducements” these days?
    [/quote]

    The ability to qualify for pensionado status with only $1000 of guaranteed income and the ability to buy into CAJA (though we seem to have a profound disagreement on that). Very few nations offer anything that generous to prospective retirees.

    With regard to your comment about baby boomers as the “bulk market” – it may be that they want some US retirees relocating there but not hordes of them. If that’s true then their reduction of the inducements makes perfect sense.[/quote]

    Once again some disagreement with your views…. friendly in nature. 🙂

    The $1000 number is way too low to honestly live in CR unless you’re going to adopt a Tico/Campesino lifestyle. So that’s not really a plus for those believing they can make it in CR with that level of income unless they are also drawing down on a nice nestegg as well. Nor is it an advantage to the government of CR. Given the choice one would have to believe that if they truly don’t want “hordes” seeking retirement in CR that they would be more inclined to seek higher net worth retirees that would not likely have to compete in the job market in CR to make it (illegally) when relocating to CR. Nor do I believe they want people that will be a drain on the system as we have discussed with CAJA.

    We can both agree that while you see the “ability” to join CAJA as an advantage, perhaps based on your projected retirement income and the small fee should your income be very close to the minimum required for residency. I see the REQUIREMENT of MANDATORY participation in CAJA as a major disadvantage based on the ROI I would receive on the level of premium I would be forced to pay for a plan I most likely would not use.

    This also brings up investment and job creation by retirees of differing income levels. If CR was thinking this through they would know that higher income retirees with more disposable income create jobs and spend money on more than just scrapping by. Unfortunately the same cannot be said of someone that perhaps meets the bare minimum requirements for residency that is left with $870/ month to spend living after they are forced to contribute to CAJA.

    This isnt a dig on anyone or class warfare…. just reality and economics. As for CR’s moves making “perfect sense”…. live here a while and try using that term in regards to the way this government, or for that fact ANY government, operates!!!!

    Hopefully the next president sees the fantastic potential and the current problems and addresses both before it’s too late!

    #161587
    Imxploring
    Participant

    [quote=”sweikert925″][quote=”imxploring”]
    The $1000 number is way too low to honestly live in CR unless you’re going to adopt a Tico/Campesino lifestyle. So that’s not really a plus for those believing they can make it in CR with that level of income unless they are also drawing down on a nice nestegg as well. [/quote]

    Whether it is [b]wise[/b] to try to live on $1000/month wasn’t the point, you asked me for an example of how Costa Rica was offering inducements to retirees and I gave you one. But since you raise the subject it is certainly easier to live on $1000/month in CR than it would be in the US.

    CR does offer special consideration to high income residents through the inversionista program. You may not think they offer enough under that to induce very many high income expatriates but you can’t deny that they do have some type of program in place to lure them.
    [/quote]

    Agreed… $1000 goes further in CR. But even when they upped it from $600 the new number was unrealistic. An inducement that is unrealistic really can’t be counted as one. In some ways it’s a trap. Reality would be a better start if CR is looking to attract retirees with a chance of making it in a reasonable fashion that don’t end up having a very bad experience in relocating to CR. George will give you the good, the bad, and the ugly so you will know what I’m talking about.

    The investor program does provide another avenue, however, we still have not gotten an answer on CAJA participation and rate. That makes a big difference. Also the investment of $200k or more in what might be a less than liquid investment is VERY different than the commitment/risk which a pension applicant makes with residency.

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