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I’m curious about the reality of health care in CR. Do most expats have the INS coverage only or do they/you carry additional insurance (BUPA)? What is the real cost (approximate)? I’m looking for something comparable to an HMO in the states.
I will be living in southern pacific CR, there is a new hospital in Cortes that looks good. Has anyone actually used this facility?
Thanks, Bruce!!
Our good friends moved to Costa Rica. One of the most important reasons for the move was that they were unable to obtain ANY insurance for the wife because of a chronic condition. So getting CAJA was a real godsend for them. Recently (just after getting residency/CAJA approved), she had to have an emergency appendectomy. The local clinic did the initial diagnosis and sent them to the Alajuela hospital for further testing and the surgery.
Waiting in the emergency area was very long and arduous, especially since the husband possesses limited Spanish. They were really helped by many Ticos (strangers) who were also waiting. It took almost two days for her surgery to happen. The surgery was successful. They had to learn to exist in the eight-room wards and communicate with the nurses and docs as the recovery week ensued. It was a week fraught with challenges and learning to use the healthcare in a totally different culture.
However, when she left the hospital after nearly a week, a successful surgery, medications, many tests and a long-aftercare to watch for infection (as opposed to “treat ’em and street ’em” even in good hospitals in the States), they walked out with a wave and not one penny owed.
What they learned will help all of us who may need the CAJA for more intense care in the future. For instance, they found out that they could hire a nurse for private duty to stay with a patient at night..making sure that good care is received 24 hrs per day.
Is it different? Yes. Is it slower? Yes. Did it work….absolutely.
We know folks who blend their private INS coverage for private hospitals with their CAJA coverage.
[quote=”sueandchris”]Our good friends moved to Costa Rica. One of the most important reasons for the move was that they were unable to obtain ANY insurance for the wife because of a chronic condition. So getting CAJA was a real godsend for them. Recently (just after getting residency/CAJA approved), she had to have an emergency appendectomy. The local clinic did the initial diagnosis and sent them to the Alajuela hospital for further testing and the surgery.
Waiting in the emergency area was very long and arduous, especially since the husband possesses limited Spanish. They were really helped by many Ticos (strangers) who were also waiting. It took almost two days for her surgery to happen. The surgery was successful. They had to learn to exist in the eight-room wards and communicate with the nurses and docs as the recovery week ensued. It was a week fraught with challenges and learning to use the healthcare in a totally different culture.
However, when she left the hospital after nearly a week, a successful surgery, medications, many tests and a long-aftercare to watch for infection (as opposed to “treat ’em and street ’em” even in good hospitals in the States), they walked out with a wave and not one penny owed.
What they learned will help all of us who may need the CAJA for more intense care in the future. For instance, they found out that they could hire a nurse for private duty to stay with a patient at night..making sure that good care is received 24 hrs per day.
Is it different? Yes. Is it slower? Yes. Did it work….absolutely.
We know folks who blend their private INS coverage for private hospitals with their CAJA coverage.[/quote]
My wife and I depend solely on Caja and have learned how to work within their requirements. We do not wait in long lines at 5AM to get a non-emergency appointment. We go in late morning or afternoon and the appointment has never been more than two days later.
My wife has been treated for two unrelated cancers, heart stents and suffers from diabetes with neuropathy, fibromyalgia, arthritis, gout and elevated blood pressure and cholesterol.
We have been totally satisfied with our care and preventive care. With a total of just over two months in hospital we have never found it necessary to have someone babysit. The nurses are very good and very dedicated to our care.
My Spanish is passable and my wifes is non-existent but the doctors all speak English and there is always someone nearby who can assist with translation for the nurses and receptionists. If you learn to work within the system the results areas good or better than the medical syste in the States or private care here. 😀
By the way…Hospital San Juan de Dios is one of the top cancer centers ib the world.
I know that you have had good experiences with the CAJA. Do you know of any way to avoid that lo-o-o-ong wait in the emergency/waiting area that goes along with admission for an approved surgery or treatment? Can your local CAJA doc help navigate that issue?
This [i]”Do you know of any way to avoid that lo-o-o-ong wait in the emergency/waiting area that goes along with admission for an approved surgery or treatment?” [/i] and [i]”Can your local CAJA doc help navigate that issue?”[/i]really sounds like some ‘trick questions’?
She received [i]relatively quick treatment[/i] since it was an emergency….
Sorry to say, that if she had [i]planned on having this surgery[/i], it may have taken a year or more.[quote=”blanzl”]I’m curious about the reality of health care in CR. Do most expats have the INS coverage only or do they/you carry additional insurance (BUPA)? What is the real cost (approximate)? I’m looking for something comparable to an HMO in the states.[/quote]
There is nothing in Costa Rica that equates to an American HMO.
There are essentially two options for obtaining health care in Costa Rica. Once you are a legal resident, you are required to enroll in the CAJA whether you plan to use it or not. Some folks have enjoyed great service there; others, not so much. A great deal depends on the circumstances. Like many American HMOs, the CAJA suffers from a chronic lack of resources and perhaps some questionable management and leadership. If you’re happy with an iffy American HMO, you’re likely to be happy with the CAJA.
The second option is to seek care in the private sector. You can pay for that care in cash, you can buy medical insurance from INS (or perhaps sometime soon another carrier), or you just might be lucky enough to have a U.S.-based policy that will pay for care in Costa Rica. Medicare will not pay for services rendered outside the U.S. If you rely upon an INS policy, reimbursement will be governed in part by whether you receive services within their network or outside it.
In the private sector, you can doctor shop to your heart’s content, and you can obtain medications that the CAJA does not provide. You can order your own laboratory work, engage your own physical therapist, etc.
The cost of coverage by either INS or BUPA is based in large part on age. What’s more, both of them (but not the CAJA) exclude coverage for preexisting conditions, and they may surcharge you to cover conditions related to your preexisting condition. In my own instance, for example, INS excluded coverage for my very well controlled diabetes but also surcharged me (but not my wife) 60% to cover cardiac problems even though I have no history of them. That’s because cardiac problems are commonly linked to diabetes.
We terminated our INS coverage due to the high cost, the surcharge, and the limited rate of reimbursement for care outside their network.
i’ve heard good and bad reports about the caja system — Waggoner and his wife have good reports, but i just talked to a neighbor of mine who has been told she has a cancerous tumor underneath her eye socket that is causing her pain, tingling, numbness, and sleeplessness and the test they said she needs is being scheduled TWO YEAR FROM NOW!!!! I doubt she would be alive to have that test, but who knows. so it would be good to have a stash of cash for medical emergencies if you are forced to wait for some kind of treatment that may or may not be life-threatening.
[quote=”sueandchris”]I know that you have had good experiences with the CAJA. Do you know of any way to avoid that lo-o-o-ong wait in the emergency/waiting area that goes along with admission for an approved surgery or treatment? Can your local CAJA doc help navigate that issue?[/quote]
What we face is the difference in the medical culture. You may have to wait the same length of time in the private practice but you are provided with comfortable seating and a variety of magazines to pass the time but Caja does everything in the most cost effective way possible. You get to sit on uncomfortable benches or plastic chairs with nothing to pass the time.You may pass the same amount of time but it is made more bearable in the private industry and you pay for the comfort. Be prepared with a pillow if necessary and something to pass the time.
There are two things that get you faster service in the Caja system…age and a true emergency. I’m 70 years old so get priority when waiting for preventive care at the local clinic.
My wife is in HSJD waiting for cancer surgery right now and I have to go see her now but I will be back this afternoon to add to this.
[quote=”DavidCMurray”][quote=”blanzl”]I’m curious about the reality of health care in CR. Do most expats have the INS coverage only or do they/you carry additional insurance (BUPA)? What is the real cost (approximate)? I’m looking for something comparable to an HMO in the states.[/quote]
There is nothing in Costa Rica that equates to an American HMO.
There are essentially two options for obtaining health care in Costa Rica. Once you are a legal resident, you are required to enroll in the CAJA whether you plan to use it or not. Some folks have enjoyed great service there; others, not so much. A great deal depends on the circumstances. Like many American HMOs, the CAJA suffers from a chronic lack of resources and perhaps some questionable management and leadership. If you’re happy with an iffy American HMO, you’re likely to be happy with the CAJA.
The second option is to seek care in the private sector. You can pay for that care in cash, you can buy medical insurance from INS (or perhaps sometime soon another carrier), or you just might be lucky enough to have a U.S.-based policy that will pay for care in Costa Rica. Medicare will not pay for services rendered outside the U.S. If you rely upon an INS policy, reimbursement will be governed in part by whether you receive services within their network or outside it.
In the private sector, you can doctor shop to your heart’s content, and you can obtain medications that the CAJA does not provide. You can order your own laboratory work, engage your own physical therapist, etc.
The cost of coverage by either INS or BUPA is based in large part on age. What’s more, both of them (but not the CAJA) exclude coverage for preexisting conditions, and they may surcharge you to cover conditions related to your preexisting condition. In my own instance, for example, INS excluded coverage for my very well controlled diabetes but also surcharged me (but not my wife) 60% to cover cardiac problems even though I have no history of them. That’s because cardiac problems are commonly linked to diabetes.
We terminated our INS coverage due to the high cost, the surcharge, and the limited rate of reimbursement for care outside their network.[/quote]
If you might say, what then was your decision regarding health coverage here in CR??
[i]”You may have to wait the same length of time in the private practice but you are provided with comfortable seating and a variety of magazines to pass the time but Caja does everything in the most cost effective way possible. You get to sit on uncomfortable benches or plastic chairs with nothing to pass the time.You may pass the same amount of time but it is made more bearable in the private industry and you pay for the comfort”.[/i] I cannot agree with this post!
[b]Waggonner[/b], I understand that you and your wife have received good care, but when given an appointment at a private facility, we have never had to wait more than a few minutes for our appointment.
I hope your wife has another successful surgery, today.Sue, right now we’re paying cash for the limited medical care we need. We pay cash for all our meds. We consider our monthly CAJA enrollment fee to be a contribution to a system we intend never to use.
Senior citizen that I am, I’m enrolled in Medicare Part B and thus retain the option to return to the States to obtain non-emergency care. Until she’s eligible for Medicare, my child bride retains her Blue Cross/Blue Shield which only covers care in the U.S., as well.
We’ve been looking into a travel insurance policy we can buy for a full year and which would cover us in Costa Rica for major medical events that would require hospitalization.
@Waggoner41: Best wishes to your wife for a successful outcome!
[quote=”maravilla”]i’ve heard good and bad reports about the caja system — Waggoner and his wife have good reports, but i just talked to a neighbor of mine who has been told she has a cancerous tumor underneath her eye socket that is causing her pain, tingling, numbness, and sleeplessness and the test they said she needs is being scheduled TWO YEAR FROM NOW!!!! I doubt she would be alive to have that test, but who knows. so it would be good to have a stash of cash for medical emergencies if you are forced to wait for some kind of treatment that may or may not be life-threatening.[/quote]
In this case, could your neighbor afford Tx out of CR? does she have access to health care insurance in USA? Britain? is she a Tica/Tico?
Though living out-of-country, she if a US citizen could consider applying for SS disability and/or Medicaid…..
Lets say part of fullt imte of year I am in CR, but I officially am still a US citizen and citizen of my home state of NC.
Possible if, with English language records (these days, almost impossible to get translations of records), could be possible to be aprpoved and Tx in NC and/or USAI do disability cases for a living, used to do Federal and Medicaid, now just Medicaid…..PM me if you want, will need some info…..and not guarantee I am 100% right, but something to consider……nice if one can have foot for health in CR and their native country, if possible……if an expat…know a Brit lady that gets insurance in the States, bust is legal resident and can get Tx in UK if she is over there and needs help…….
[quote=”waggoner41 I’m 70 years old so get priority when waiting for preventive care at the local clinic.[/quote]
Thats already better then the USA and UK, where the older you are, the less people want to do for you, at least in Govt programs,,private often too…..unles syou got a lot of $$
Even as a busy and fairly health 70 yr old, you would be far down on a transplant list if you were in great shape except for say ,a kidney, but very healthy other wise…..
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