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We were wondering if anyone knows how one may be eligible for medical coverage in Costa Rica? Does one have to be a citizen, or can one be a pensionado, or rentista? (or are those two terms synonamous???) We were talking with someone the other day and they asked us that question and we realized we didn’t know. How much is coverage for a couple? Is there a doctor there who would accept medicade/medicare? Is there someone we should contact about all these questions?
“Rentista” and “pensionado” are different statuses of legal residency. They are not synonymous(sp?) with “citizenship”.
Medicare and Medicaid do not cover services provided outside the United States, so that’s off the table. Once you have legal residency, you can enroll in the national CAJA medical system. The monthly premium is based upon ability to pay.
INS, the national private insurance monopoly, also sells at least two medical insurance policies with varying levels of coverage, deductibles, etc. I *think* it is true that you do not have to be a legal resident to purchase an INS policy, but somebody verify that for me, willya?
There are also international companies which will sell you medical insurance policies which will pay for care rendered in Costa Rica. Their coverages and premiums vary.
INS can be purchased if you show proof of filing for residency. That can be provided by the lawyer who is handling your application.
Be advised that INS will cover pre existing conditions but a surcharge may be applied to the normal premium.Buena Suerte
HarveyHarvey, it’s not my intention to be argumentative, but what you say above about INS covering pre-existing conditions is not consistent with what I’ve been told elsewhere. Can you say a little more about this? It’s important to me because right now we’re trying to sort out the options and I have diabetes. If you can put me straight, I’d be forever grateful.
Dave
Hola David!
I applied for INS in December and finally received my membership card yesterday. My agent, through a relative, took my application and advised that pre existing conditions would be covered. In my case the condition was stents which I listed on the form. This is contrary to information I received when joining ARCR. The brochure I received states that pre existing is not covered. It also mentions that there is a 75% reimbursement for health related expenses. My agent had never heard of that % and provided me with the Regional plan that has 80 or 90% reimbursements. I was charged 130% additional surcharge from what was originally quoted due prior health issues.
My residency is not yet completed, at which time I may apply for CAJA coverage.
Let me know if you need additional info or agent referral.
HarveyMuchas gracias, senor Harvey.
Yes, I would like to know with whom you’ve dealt, if that person speaks decent English. (You’ve seen the full extent of my Espanol.)
Would you be willing to share some of the details of your coverage either in this forum or privately, via e-mail? I’d like to know if your coverage is for you alone or your family of ? What is your premium and does that include the apparent 30% surcharge? What is your deductible/co-pay situation? Have you actually filed any claims and, if yes, how has the reimbursement process gone? What exclusions are there in your policy? And . . . anything else you deem relevant.
With regard to the inclusion of coverage for the pre-existing condition, are you able to point to specific language in your policy where that inclusion is mentioned, or are you relying upon the assurances of your agent?
Thanks in advance.
Dave
Hola David!
I would be happy to discuss the info with you by email or phone.
email is harvcarp@adelphia.net.
I am currently in Granada and will return Tuesday night. If you wish, I will furnish the phone # of my agent.Harvey
My computer went down and am just now retrieving my messages. Thanks for the information on this topic Dave. Paul and I are definitely interested in finding out as much as possible. We are going to retire down there in another 1 1/2 years and need to know all the loop holes we can find before the move, especially in regards to health care. We read somewhere that insurance coverage is about $400 a year for a couple, but I like to talk with people and find out the real story. Things can change quckly sometimes, and it’s good to keep up with all the latest. I knew that rentista and pensionado were different from citizenship, but those first two terms always confuse me. I know people often move down to CR and don’t have any intention of acquiring citizenship in that country. So, how do people like that manage to get health coverage? We’ll probably be pensionados at first…and then will consider the option of citizenship. We were told that if we live there 10 years, we can “earn” our citizenship. It’s hard to know, because there are so many different stories floating around.
Anyway, I liked what you said, and also what Harvey said and hope to find out more about this topic.
Diane
There are different classes of legal “residency”. Residency simply means that you have a right to continued presence in the country and to most or all governmental benefits, such as health coverage. “Citizenship” means that you have all such rights and privileges and that you can vote and run for office. After seven years of residency (not necessarily continuous) you may apply, take the test, and thereby seek citizenship. I’ve heard that it’s difficult.
As a resident (pensionado, rentista or whatever) you can join the national CAJA medical care system. As an *applicant* for residency, one of the others has said here that you can purchase health care insurance from INS, the national insurance monopoly.
I have recently read that the monthly premium for a couple over 55 years of age in the CAJA program is now $40. A policy from INS will be much more expensive but may give you more flexibility in choosing your care providers and shortening the waiting periods for services.
Do you have any idea how much more expensive the INS would be a month for a couple over the age of 55? Also, what Harvey said about reimbursements of 80-90%…is that for things such as pills, medicines, etc. or for actual coverage of lab work, referred doctors, etc?
Yes; the 80-90% appplies to medicines, lab work and doctors.
For an idea of the cost for INS you can contact my agent at 827-7979 (Kenneth Garita) or if you are a member of ARCR, they can quote you as well. In fact, membership is not required to get the info.
INS will cost much more than CAJA!
HarveyThanks so much for your agent’s number. We’ll give him a call when we’re down there next time. I save all numbers that are given to me re: people to see in Costa Rica. That’s really great that there’s such a fantastic reimbursement program. I’m impressed by that. We used to be members of ARCR, but didn’t reapply after our membership expired. I’m sure they’re good, but we thought we’d check out other avenues for awhile.
I’ve just stumbled upon another potential resource. Some gringos here in C.R. have formed a Panamanian corporation so that they can sell health insurance written by a British not-for-profit corporation. Unlike the INS policies, it will pay for care worldwide. Apparently this company has been in operation since 1971, so it has some history, and one of the terms of the contract is that they can never terminate your coverage for claims you submit. So once you’re in, you’re in.
Privately, Harvey has shared with me the cost of his enrollment in the INS plan. Once I’ve met the agent for this other outfit, I’ll try to post some more details here.
Wow! This Panomanian Ins. corp. sounds very interesting. Do you happen to know the name and how we would get ahold of them? Worldwide insurance is the way to go, especially if one plans on traveling around. I look forward to hearing about your experience with the INS agent as well.
Diane
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