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We just got on the CAJA and, like many of you, are wondering whether we should purchase additional insurance here in Costa Rica and, if so, what.
Does anyone have experience with INS Regional Medical Insurance?
Does anyone have other suggestions?
My husband will be eligible for Medicare in a month or two but I won’t be for several years. I’ve read many threads here and on other forums and can see that the opinions about sticking with the CAJA are as varied as the number of people who write.
So I’m not asking about that. I’m presupposing that the decision has been made to get additional coverage and am looking for suggestions. Thanks!!!
Debi, your options are essentially three: First, you can purchase INS’ plan with all its co-pays, deductibles, exclusions of pre-existing conditions, in/out-of-network limitations, possible surcharges, etc. We found INS coverage to be skimpy relative to the cost and dropped it.
Second, you can purchase an international health insurance policy or maybe a long-term travel insurance policy. These won’t be cheap either, and one wonders what legal protections you’d have if they deny a claim or terminate your coverage when you become ill.
Third, you can pay cash in the Costa Rican private sector.
If you currently have coverage in the U.S., or when you do (including Jim’s Medicare eligibility and your own in the future), you can elect to maintain that and use returning to the States as a “fallback” position. At the present time, and for the foreseeable future, Medicare will not pay for any service rendered outside the United States.
[quote=”debiruns”]We just got on the CAJA and, like many of you, are wondering whether we should purchase additional insurance here in Costa Rica and, if so, what. Does anyone have experience with INS Regional Medical Insurance? Does anyone have other suggestions? My husband will be eligible for Medicare in a month or two but I won’t be for several years. I’ve read many threads here and on other forums and can see that the opinions about sticking with the CAJA are as varied as the number of people who write. So I’m not asking about that. I’m presupposing that the decision has been made to get additional coverage and am looking for suggestions. Thanks!!![/quote]
We generally go to a private doctor in cases where Caja doesn’t fill our needs and it has only happened twice in four years.
1 ~ On a Saturday I had a ruptured appendix and the private doctor confirmed and sent me to San Juan de Dios. Cost: 20,000 colones.
2 ~ Treatment for a pernicious fungal infection requiring two visits and a VERY expensive antifungal medication.
Cost: 20,000 colones for two visits and 95,000 for antifungal medication.
The cost has been far less than any insurance and without the hassles of all the requirements. 😆
How many colones are there per dollar. I need this equation to compute what the cost is in US dollars.
At the present time, the “buy” rate is $1.00US = c492. That is, you’ll get c492 if you buy them with $1.00US. The rate fluctuates somewhat, but for the last couple of years it’s been hovering right around $1.00US = c500.
The “sell” rate, the rate that you’ll pay in colones to buy one U.S. dollar is generally a few colones higher. Right now, it’s about c503 = $1.00US.
[quote=”summerjones”]How many colones are there per dollar. I need this equation to compute what the cost is in US dollars.[/quote]
You can keep up with the conversion on a daily basis at [url=http://www.bccr.fi.cr/index.html]Banco Central de Costa Rica[/url]
On the right hand side select [b]Tipo de Cambio y Tasas[/b]
I agree with waggoner41
When I paid into the private medical insurance, I never needed it (Murphy’s Law, right?) and over 4/5 years that was a ton of money so I let that lapse and so now in addition to paying for the CAJA every month, I pay for private medical care when I need it …
The most recent ‘somewhat urgent’ surgery needed was for a hernia… I wrote about that at:
[url=www.welovecostarica.com/public/3299.cfm]How The President of Costa Rica And I Ended Up Undressed in the Same Room![/url]
Soooooooooooo-what DOES CAJA pay for and is it worth getting? I’ll be arriving soon (Nov) to CR to live myself. I have excellent Medicare and BC/BS Secondary insurance which I do understand isn’t worth a hoot and a hollar in CR – just curious tho. Has anyone had to spend any time (say a few days to a week) in the hospital in CR and what kind of costs were associated with that (not to be too personal).
Coverage from the CAJA is pretty broad but resources are scarce, so actually getting some services is problematic at least in some areas. For emergency care, it appears to be pretty good. For ongoing primary care and specialty care, it’s sometimes another matter. There have been reports, for example, of very long delays in having some diagnostic procedures, and it was reported some months ago that one of the hospitals was backed up a quarter of a million Pap smear interpretations.
If you want to be in charge of your own health care, you’ll probably want to plan on paying cash for some of it, at least.
Once you become a legal resident, you are [b]required[/b] to enroll in the CAJA. It’s not an option. But that doesn’t mean you have to actually use it. While reports are mixed, it appears that you cannot enroll in the CAJA until your application for residency is approved.
U.S. Medicare does not pay for any services rendered outside the U.S. Some BC/BS policies DO pay outside the States. That coverage may be limited to those traveling or to just emergency care. It’s important to get a [u]definitive[/u] answer from your plan administrator.
We’re covered by the State of Michigan’s BC/BS and have gotten an equal number (several) of “Yes” and “No” answers. You really need to go to the horse’s mouth on this one.
If you do decide to buy additional coverage outside of CAJA, consider joining ARCR ( http://www.arcrmembers.net ). They offer the INS medical coverage at a group discount. If I remember correctly the quote I received from an agent was $5500 (US)for one year for my wife and I. At ARCR the price for the same coverage at the time was $2900 (US).
This is of interest to my husband and me. We are planning on living in CR for @6 mos. of the year when my husband reaches 62 in @ 2 and 1/2 years. Had originally planned on being full time residents (we have a home on the Caribbean side), but circumstances have changed and we will need to spend time in the US due to family responsibilities. Health insurance is the big issue for us. Of course we can afford the CAJA and planned on getting some type of supplemental coverage, BUT when we are in the US….we got nothin’. We had checked into some of the Global Coverage companies, and it looks like we would be paying @5000 per year as long as we don’t spend greater than 6 months out of the year in the US and provided we stay healthy until we apply! Curious to know if the ARCR policy would cover us when we are in the US. Also, I had contacted the site’s “insurance expert” a few weeks ago, and haven’t gotten a reply yet.
ARCR doesn’t sell insurance. Just as they have affiliated attorneys, they have an affiliated insurance agency that represents INS.
I wasn’t aware of any ARCR discount program, but I can tell you that INS does offer a policy that will cover you in the U.S. as well as in Costa Rica but it ain’t cheap. And INS will exclude coverage for any pre-existing conditions and they may surcharge you for “related” conditions. I, for example, am a well controlled diabetic. They wouldn’t cover anything related to my diabetes, and they surcharged me 60% to cover cardiac care because that’s what most diabetics die from.
INS’ policies are priced on the basis of each individual’s age and sex.
The best way to find out about ARCR coverage (Group) is to call them direct ((506) 2-233-8068, (506) 2-221-2053). Ask for a quote on medical and they will transfer you.
The difference in the annual payment from an independent agent and the one working with ARCK was quite large.Up here in the Nuevo Arenal area, a former ER doctor and his nurse wife came up with a terrific solution to the virtually non-existent emergency services in the area (response time is well over an hour and that’s being conservative). They formed a heart attack response group with the individuals in the group trained in both compression-only CPR and use of a defibrillator and oxygen. I hope we never have to use the service – or provide it – but I am certainly glad its there.
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