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Our situation regarding our move to Costa Rica has been complicated somewhat by a scary incident this last December. My husband (a VERY fit mountain biking athlete with an outstanding diet, non-smoking, non-meat-eating, very light drinking guy) had a massive heart attack. He was rushed to the hospital where he had an angioplasty and stent. Miraculously, he has no heart damage – probably due to his fitness level.
However, now we have found out that any international insurance policy will exclude his new existing condition, and we may not even be able to get emergency flight insurance. We have been advised to keep his current US health insurance in the unlikely event that he has further heart problems.
I was glad to read the article about what seemed like very cheap care for one of the Members. But I would really like to hear about anyone else who is or had dealt with this kind of issue. What have been your specific experiences???
Thanks so much, Sue
Sorry to hear about your situation ‘sueandchris’ and I’m assuming that after this scare that quality of life is more important than ever…
I am not an expert in insurance but do know that we have some great Doctors here and would suggest that on your next visit down here that you bring all your husband’s medical records with you and sit down with a Costa Rican heart specialist to ask him what sort of options might be open to you…
I will try and get some names for you …
Scott Oliver – Founder
WeLoveCostaRica.comThanks Scott:
Oh boy, do we ever savor our lives more! Thanks so much for the names of cardiologists. We have also talked with your recommended international insurance provider.
But I am also very much hoping that folks who have retired there with a “non-insurable, pre-existing condition” might also respond with their stories and how they made decisions to give up stateside insurance when they moved to Costa Rica.
Love this site – I always get the nicest responses! Sue
We have a health insurance policy from INS which excludes coverage for my diabetes and high blood pressure and which applies a 60% surcharge to my premium (but not my wife’s) for coverage for cardiac care. INS will probably exclude all cardiac care for your husband, too, although they might just apply a surcharge.
As legal residents (pensionados) we are also enrolled in the CAJA system mostly as a means of tossing a few dollars into the kitty each month. We hope never to have to take advantage of it. Only citizens and legal residents may enroll in the CAJA.
We’re both covered by our U.S. Blue Cross/Blue Shield plan and will keep it ’til we’re eligible for Medicare. For the time being, the mail-in drug service makes it worthwhile. At age 65, we’ll have a decision to make. In order to keep the BC/BS as a Medigap plan, our former employer requires that we enroll in Medicare Part B. We’ll probably do that as a final hedge against something happening that requires that we return to the U.S. for care.
David:
Is medicare accepted at CIMA?
I think in the near future you will see more US health insurers cover specific countries, including CR. After all, it is good for their bottom line.As far as I know, Medicare will not pay for any medical services outside the U.S. There may be an exception for some emergency care but I’ve not heard of it.
While there is a certain logic to the argument that they should pay for care here and elsewhere (I’d love it), I can see a long uphill battle. To do so, Medicare would lose any control over the quality of care, etc, and they would be shipping U.S. dollars outside the country. What’s more, the prospect of having to pay fees in currencies that fluctuate daily against the dollar and establishing all those rates of payment, one for each country, would be nightmarish. I just don’t see this coming, attractive as it might be to us.
David: This was a very interesting response. We have thought of keeping my husband’s Blue Cross Blue Shield policy, but it is pretty expensive ($600/mo). This policy was in force before the heart attack and therefore has no restrictions. It may be that he can go in and out of that policy without any restrictions – we are waiting to find out. If you let your BCBS plan in the states lapse – couldn’t you just get another Medigap plan if you returned? I believe that these plans can’t exclude you. Are prescriptions more expensive in Costa Rica than in the States?
Can you clarify the general costs (in dollars) for your INS insurance? You note that you also participate in CAJA…is this a kind of fall-back position?
We would be legal residents under the pensiando system. I think it is probably pretty important for us to get started early on that process to help solve some of these issues!
Thanks,
Sue
Sue, under the terms of our retirement plan, our BC/BS coverage *as a Medigap plan* becomes free when we turn 65 and enroll in Medicare Part B. The catch is that there is an open enrollment period and, as you’ve recently learned, one cannot time one’s health care emergencies to coincide with open enrollment periods. I’d hate to be comparing Medigap plans from my CCU bed while heavily sedated. So we’ll keep the BC/BS from Day One.
INS’ health insurance policy premiums are age- and sex-based. That is, males in the 60 – 64 age range pay a different premium than females aged 55 – 59. With my sixty percent surcharge, we’re paying INS just over $2,000 for six months of coverage.
The good news is that INS pays on the first dollar although there are some co-pays. What’s more, INS will pay for services outside Costa Rica but I think I know that they pay Costa Rican rates, so if you bought health care insurance from INS and then went to the U.S. for a hip transplant, you’d still come home with a whopping unpaid balance.
Some medications are cheaper in Costa Rica and others are not. And some, while “cheaper” are nevertheless not what you’d mistake for “cheap”. If you have one or more chronic conditions, you may well find that the cost of a month’s medications is pretty expensive. For this reason, too, we’re hoping to retain our BC/BS coverage which includes a mail-in pharmacy benefit. I send in prescriptions and they send my meds to our mail forwarding company in Florida who sends them on to us in Grecia.
We pay very little in tax here in Costa Rica. Our primary motivation for enrolling in the CAJA system is to throw them a few extra dollars ($40US) each month. That said, if we need it we’ll use it, but we’ll try not to.
We are planning to move to CR in the very near future. We are retired & have Blue Shield provided by my husband’s Union retirement plan. Blue Shield confirmed they will continue to cover 70% in CR. We also are provided Prescription coverage. I am very interested to know more about the “Florida mail forwarding” of prescriptions.
Love this site too. Thanks much!
DosGitanosThese 4 cardiac specialists were recommended to me by a dear Doctor friend at Hospital CIMA – I’m assuming they can be easily found through Google
1. Dr. Jorge Arauz, cardiologist – interventional (stents, angioplasty etc.)
2. Dr. Salomon Friswasser – Cardiologist – echocardiogram
3. Dr. Allan Lanzoni – cardiologist – pacemakers, internal defibrillators etc.
4. Dr. Carlos Mas – Cardiologist – PediatricScott Oliver – Founder
WeLoveCostaRica.comrmayher, Aerocasillas, Jet Box, Mail Boxes, Etc. and maybe other companies provide mail forwarding from Florida to Costa Rica and other Latin American countries. We use Aerocasillas.
They give you a Post Office box address in Miami and a physical street address in Doral, Florida to which mail and packages can be sent from the U.S. You are assigned a mail code which begins with the local airport code (Juan Santamaria International Airport in San Jose Costa Rica = “SJO”) and a number and mail and packages are sent to the Aerocasillas office of your choice in Costa Rica.
To correspondents and shippers in the U.S., these addresses look like any other mailing address, so buying via the Internet, having your mailorder pharmacy send meds, etc.is transparent to them.
Aerocasillas and the others take care of getting your merchandise through Costa Rican Customs.
For all this, of course, there is a cost.
Dear Sue and Chris:
I would suggest that you drop by CIMA or call the next time your are in Costa Rica for a visit. Last May I was on George Lundquist’s tour and we went to the hospital. While taking the tour, their new director introduced herself to George and my fellow tour mates. She is from Texas and a very interesting woman. Her information, thoughts, and ideas on health care in Costa Rica were both excellent and very helpful. You may want to contact George through his website and get her name. She had previously managed two hospitals in the States that currently own CIMA also.
Thanks,
Tom in Portland on a budget.rmayher, if your U.S. Blue Cross/Blue Shield plan will pay 70% of the cost of medical care received in Costa Rica then your needs should be well met, as long as you can afford to pay the bills here and wait to be repaid. With the difference in costs between the U.S. and Costa Rica, the 30% you will ultimately be responsible for will very likely be less than the copays you’re used to now. Of course, your annual deductibles will probably still apply (in U.S. dollar amounts).
If we had your coverage, it’s unlikely that we would be buying health insurance from INS or that we’d be enrolled in the CAJA.
The only question will be about what you’ll be subject to when you turn 65 and become eligible for Medicare. Then what will your coverage be?
David, Thanks for all the information. It is wonderful news that our mail order prescription shipments will not be a problem. Also, we are well past 65 yrs. & know that Medicare will not be a factor. We have no deductables & no co/pay with BP/BS. Our Union pension is small but our medical coverage is great. What about emergency air evacution – do you suggest we have insurance for this and do you have any idea of the cost? rmayher
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