medical coverage in Costa Rica

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Viewing 11 posts - 16 through 26 (of 26 total)
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  • #181922
    dsullivan
    Member

    Gracias, David. You have been a huge help and a wealth of information!
    Pura Vida!!!
    Diane

    #181923
    DavidCMurray
    Participant

    Yesterday, we met a representative of a Panamanian corporation which represents a British not-for-profit health care insurer who, in turn, offers worldwide health care coverage. The available plan provides $2US million of coverage annually with a $2,000US deductible. The company is conservative about accepting applicants with pre-existing conditions but with my diabetes I was not immediately ruled out.

    The policy is quite comprehensive except that no coverage is afforded for dental, eyeglasses or long-term (nursing home) care. The rates quoted are based on the applicant’s age group and residency in Central America. Nevertheless, if the appropriate place to receive care is the U.S., Canada or Europe, the coverage extends there. And there is air transportation coverage.

    The catch is the premiums. This policy is much more expensive than what is offered by INS, and more expensive still than enrollment in the CAJA system. But the freedom to obtain care outside Costa Rica and the guarantee that once accepted you can never be terminated (except for non-payment of premiums, of course) may make it worthwhile.

    #181924
    *Lotus
    Member

    David this may be a silly question, but can one buy this health insurance if you are a U.S. resident and living in the U.S.?

    #181925
    DavidCMurray
    Participant

    Lotus, my answer is a qualified “Yes” (at least I think so). How’s that for waffling?

    The Panamanian corporation which represents this British corporation cannot do business directly in Costa Rica because that would be in violation of INS’ monopoly. Therefore, one must deal with them *in Panama*, even though they will be paying for services rendered in Costa Rica. And they have worked out a premium structure that assumes that most medical services reimbursed will be paid at Central American rates (much cheaper than U.S. medical costs).

    So while a U.S. resident might find his or her way into coverage by this British corporation, s/he probably could not enroll through the Panamanian corporation I’ve referred to, and the premiums would probably be higher. The expectation would be that a U.S. resident would be receiving most of his or her care in the U.S. at U.S. rates.

    (I think.)

    #181926
    *Lotus
    Member

    Thanks, and I think you must be right about the rates being adjusted for U.S. medical costs.

    #181927
    DavidCMurray
    Participant

    Since Lotus’ last post, Marcia and I have looked into what INS has to offer. Basically, it’s two plans, “Regional” and “International”.

    The Regional plan affords $200,000US worth of coverage per year. Most expenses are paid at 80% or 90% on a reimbursement basis. You pay, submit your claims, and wait. The good news is that INS pays for drugs, and they pay on the first dollar of covered expenses. There are no deductibles.

    INS International Plan affords $2,000,000US in coverage annually. It pays for essentially the same range of services, requires that you pay first in some cases, and has no deductibles. It’s much more expensive than the Regional plan.

    Costs for both plans are based upon your age group, and each has optional coverages for major (read: “huge”) medical expenses and the additional expenses of cancer treatment.

    To get the full lowdown, you need to sit down with an INS agent and go over the details.

    #181928
    dsullivan
    Member

    We will contact them when we get down there…I’ve written down the website address. Appreciate all the information. Did you and Marica go with this company? Did they charge you more due to the diabetes? (Are you the one who mentioned that? I may have it confused.) Sure do appreciate the feedback.

    Diane

    #181929
    DavidCMurray
    Participant

    Diane, we have not yet enrolled with INS but hope to do so this coming week. I’ve been chasing down medical records to prove to INS that my diabetes is not a significant exposure to them. My hope is that they will neither exclude it from coverage nor surcharge me for it. We shall see . . .

    We are members of the Association of Residents of Costa Rica which organization has an in-house INS agent who speaks pretty good English. He is the one through whom we will enroll. It’s one of the benefits of ARCR membership.

    Dave

    #181930
    dsullivan
    Member

    Paul and I were members of the arcr but dropped it awhile back. We just didn’t require the services at that point. When it gets closer to our move down there, we’ll probably re-order their services.

    If it’s not too personal, could you email me the cost of what you and your wife will be paying for the medical coverage with the INS? You can email me at the house address if you like. This will help us to understand what the rates are…even though ours may be somewhat different due to our age, etc. Paul is in his early 60’s and I’m in my 50’s. So we’re up there!!! Or, so he likes to tell me! haha.

    How long have you two (three, four?) been living there? Have you become citizens yet? I hope you will be able to have the coverage you need without having to pay extra for the diabetes.

    Diane
    dbechardcr2@hotmail.com

    #181931
    DavidCMurray
    Participant

    Regional Plan (as described earlier) annual rates are:

    Age Male/Female
    50-54 $ 953 / $1,086
    55-59 1,068 / 1,179
    60-64 1,348 / 1,364
    65-69 1,625 / 1,599

    Sorry, I can’t get this to format any better.

    These are annual rates (payable annually (or semi-annually for a 5% fee)) and provide for US200,000 in coverage. For an additional $97, you can add $200,000 of coverage for cancer, and for another $97 per year you can extend the basic coverage to $400,000.

    Since we have not yet applied, we have not resolved the diabetes matter. One of our VIP members pays a 130% surcharge (total cost: 230%) to have a pre-existing condition covered. If we’re faced with that, we’ll skip the diabetes coverage.

    Marcia and I have lived in el Cajon, outside Grecia, since September of 2005. We are legal “pensionado” residents. To qualify to apply for citizenship, you must spend an aggregate of seven years in Costa Rica, go through some bureaucratic rigamarole, and take a written test (en Espanol).

    For comparison, the International Plan for a man between 60 and 64 years of age would cost $2,677.

    #181932
    Ripple33
    Member

    Thanks for all the information. I have a question about paying a higher premium for INS to cover preexisting conditions. Please let me know where you got this information and how to obtain coverage. Unfortunately, my wife has multiple medical problems and must have some kind of coverage until we can get Caja coverage.

Viewing 11 posts - 16 through 26 (of 26 total)
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