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Does anyone have any experience or insights into catastrophic health insurance for care in Costa Rica? Our U.S. Blue Cross/Blue Shield covers only medical emergencies outside the U.S. The same will be true of Medicare when we become eligible.
I’m not concerned with paying for doctor’s office calls, lab services, medications, etc. Those expenses we can pay in cash. It’s the major expenses like inpatient care for a heart attack, stroke, etc, necessary but not emergency surgery (gall bladder, prostate, etc) and things like radiation and chemotherapy that I’d like to have covered.
I should add that I have a pre-existing condition that an insurer might either exclude, postpone coverage of, or limit its liability for.
David: Are you SURE Medicare will cover anything outside the US? It was my understanding that there was no coverage at all for Medicare recipients who need treatment and who reside outside the country (unless of course you go back to the States). As for catastrophic health insurance, I know someone who had several cancer surgeries and then had follow-up radiation — most of the expenses he paid out of pocket and the cost was somewhere around $12,000! In the States that same treatment would’ve approached a hundred grand. And I read somewhere that the cap on medical expenses for some policies issued in CR is around $18,000 for a lifetime of medical services. Even the most catastrophic illness has a pricetag of a bargain basement in Costa Rica — don’t know what your premiums would be for a catastrophic policy, but you might be better off just setting aside a sum equal to the premiums to pay for medical care yourself.
David
I would be very interested in what you discover with your research.
There is a travel and health insurance agency that has been recommended to me by quite a few people and after checking them out thoroughly, we have recently started mentioning them here.
I do NOT know if they offer the type of insurance that you are looking for but would love to hear your opinions about them after you have looked into what they do offer.
To visit their site and find out if they do indeed offer what you need, please click on the link in the middle of the article at
Scott
Marvella, I “think” Medicare will cover emergencies outside the U.S., but I won’t swear to that. I know my BC/BS policy will, and it becomes a Medicare supplement when I turn 65.
Scott, I looked at the site you cite and also at the site of a guy who advertised in last week’s Tico Times. All the policies are very restrictive with regard to pre-existing conditions. Generally, you can select your annual deductible and the premium varies accordingly.
The man whose site I visisted called this morning. He said that only one of the companies he represents is actually governed by U.S. law and only that company guarantees renewal. So the others may accept you for a year and then drop your coverage.
The policy he recommended for me costs about $3,000 per year with a $2,500 deductible, so to break even, you have to have $5,500 in expenses. And the premium goes up with age.
This just doesn’t seem to make good economic sense. Even with my diabetes (in excellent control), I’ll probably be better off keeping my BC/BS coverage, enrolling in Medicare when I’m eligible, paying cash for what I can afford here in Costa Rica and planning to return to the U.S. for what I have to lay off on Medicare.
The man I talked to did argue that we should have air evacuation insurance to pay for flying us back to the U.S., if needed. Apparently, that’s not too expensive. When I know more, I’ll let you know.
Marcia and I have our pensionado residency, too. That makes us eligible for Costa Rica’s CAJA medical plan and we are enrolled, although we have never used it. So the question becomes whether we should maintain that ($37/month for the two of us) or drop it and just plan to pay cash for everything. I dunno . . .
mmmmmm, I can’t imagine that it covers anything if you’re outside the US. I have to call them today about another matter, so I will ask, but Medicare just couldn’t be that generous! I shudder to think about paying all that money for insurance, especially when you can get heart surgery for about $5000! Insurance companies being what they are, I don’t trust them — after all they are in the business of collecting premiums, not paying claims, and the minute you have something serious happen to you, you could have no coverage at all. I’m going to start a medical fund when I am in Costa Rica and put a few hundred each month in there to cover a big medical expense, even though I’m planning on getting insurance after I get my cedula.
David, I am also on the understanding that Medicare does not cover out of the U.S. Once you are enrolled in Medicare at 65 it will not cost anything for part A coverage (hospitilization) the premium that comes out of your Social Security check is for part B (doctors, surgeons)etc. You do not need to pay for part b coverage if you don’t want it. I’m not sure if you take it then drop it what happens in that situation, especially if you would want to enroll in part b coverage at a later date. Also, from having some background in the insurnace industry, you may want to look at your BCBS policy on their defintion of medical emergency. See it they will cover it based on the SYMTOMS and not the DIAGNOSIS. ie: You go to the hospital with severe chest pains, turns out that it is only a bad case of heartburn. Oviously, not a medical emergency, but if your plan covers based on the symptoms, rather than the diagnosis, your plan should cover it. I read a story somewhere a few months ago, (can’t remember where) but it talked about a tico who was enrolled in a private plan, then when was diagnosed for something more severe, enrolled in the CAJA because he was not able to afford the co-insurance that he would have to pay. I would definatly stay enrolled in the CAJA for the cat coverage.
DebbieI have read that Medicare will take care of you outside the US, IF you are retired military or ex military. It was not clear when I read this which one had eligibility.
If this is the truth, it is NOT fair for the common folks.
It is not the truth it is a grapevine lie. The retired military and the disabled vet and some other vets do receive medical care through a program for retired military called TRI Care for life or Tri Care. If you are over 65 you have to be paying the medicare premium to be eligible for the TRI Care for life. Medicare does not pay for anyone outside of the US or the territories of the US.
So, that tale is a lie and a big myth. You had to get that from someone that is neither a vet or a military retiree
The program Vets are covered under is the VAdministration overseas medical coverage for disabled veterans because we have veterans who have served that live all over the world.
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