What do you recommend we do about Medicare?

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  • #173677
    rk_dave
    Member

    My wife and I are getting more serious about moving to Costa Rica as we watch the direction our government is going. We are both 68, retired, and on medicare.

    Our question is what do US ex-pats in Costa Rica do about medicare? Keep it going for coverage when visiting the US? Or withdraw and hope for the best when going back to the US to visit?

    #173678

    Your medicare is not available here in Costa Rica. You have three choices: (a.) continue to pay your medicare monthly for all the years you live here in case you need to return to the USA for health reasons; (b.) then apply for residency through the ARCR before you come so that you get all necessary documents before you leave the states (check ARCR website (see, http://www.arcr.net/) for complete details on their membership fee and their complete details for residency here in Costa Rica); and/or (c.) Buy private insurance here in Costa Rica which will could very well be to expensive for your budget at your age.

    Free advice, this is very important! Don’t move here without coming here for several visits. At a minimum you both need to do George Lundquist’s tour on retire here on your Social Security (see this link, http://retireforlessincostarica.com/retirement-tour/) AND the ARCR monthly seminar (see, http://www.arcr.net/seminar/)

    WHY THIS ADVICE? This is not the 51st USA south! I repeat, This is not the 51st USA state south. This country of Costa Rica is in no way functioning like the USA!

    Many, many of our citizens move here to return home in ONE to FIVE years simply because they can’t tolerate the way this country operates.

    If you have a personal income of $3,000 or more a month, then you can very like, very likely is the operative word, here afford to live in the more expensive area where expats are the main source of income and feature of the area.

    THIS IS IMPORTANT TO UNDERSTAND AND BOTH GEORGE LUNDQUIST AND ARCR CAN HELP EDUCATE – AGAIN EDUCATE – WHAT YOU ARE GETTING YOURSELF INTO BY MOVING HERE!

    Airfares can be found cheaply not necessarily on the discounted airline sites.

    HOW: Example, two-week vacation, start checking the online fares 316 days before you want to travel. All airlines post normally 330 days in advance, example for today 09/09/2015 At least United Airlines is through Thursday, 4 August 2016. So you would need to look for Thursday, 21 July 2016 to Thursday, 4 August 2016 to buy today, 09/09/2015 330 days out.

    ALSO, important: whatever national carrier that serves your hometown, create a free online account with them! Why? If you search for fares INSIDE you account, they will sometimes offer fares that are not available on just the website outside to the general public.

    Let me know if you need any information about Grecia since I have live in the area since September 2013.

    #173679
    costaricafinca
    Participant

    Although I am not an American, I do know many American citizens that return to the USA to use Medicare for medical treatment that may take to long to receive here. Most ex-pats have private insurance, as well as CAJA to cover the health care needs.
    Expect it to take [u]more[/u] than a year to get Residency, and until then you will [u]not[/u] be covered by CAJA, the socialized health care system..

    Agree with making multiple visits prior to packing up all your stuff…

    #173680
    CHERYLJK
    Member

    I plan on getting Medicare when I am eligible even though I live here now. My husband and I bought private health insurance as we are waiting for our residency. We haven’t decided if we are going to keep it once we are on the Caja, but I think we probably will. A friend of ours who has lived here for over 30 years always returns to the States at least once/year. On one of his trips he suffered a heart attack and had to have bypass surgery. He was glad he kept his Medicare.

    #173681
    maxdevil
    Member

    CAJA is only good for emergencies. Unfortunately, once you become a resident, you have to pay into CAJA, no matter what. If you need non-emergency health care, such as knee surgery for torn miniscus, be prepared to wait months, or even years for the surgery. The CAJA system is so overcrowded that nothing happens very fast. I’ve been in need of a knee operation due to a torn miniscus since February. It is now September and I haven’t heard a “peep” out of the hospital here in Perez Zeledon. The surgeon who is supposed to perform the surgery told me to be prepared to wait for up to 5 years. By that time, I may need a whole knee replacement. Be warned.

    #173682
    rk_dave
    Member

    Thank you all for your information – it has been most helpful. If I understand all of the input, we’ll need:
    1) private Costa Rica insurance for minor things (annual physical, vaccinations, minor problems;
    2) US medicare for more major issues (non-life threatening surgery or treatment);
    3) CAJA for life threatening emergencies (heart attack, stroke, shark bite)

    Does this pretty much cover the needs?

    #173683
    Andrew
    Keymaster

    [quote=”rk_dave”]CAJA for life threatening emergencies (heart attack, stroke, shark bite)[/quote]

    And snake bites 🙄 And possible alligator attacks 😆

    #173684
    costaricafinca
    Participant

    [quote=”rk_dave”]Thank you all for your information – it has been most helpful. If I understand all of the input, we’ll need:
    1) private Costa Rica insurance for minor things (annual physical, vaccinations, minor problems;
    2) US medicare for more major issues (non-life threatening surgery or treatment);
    3) CAJA for life threatening emergencies (heart attack, stroke, shark bite). Note that most exp-pats use CAJA to provide Rx’s, although not all are covered.

    Does this pretty much cover the needs?[/quote]

    I would say, once you are a Resident and are covered by CAJA and depending of the severity of your medical problem…

    1) private Costa Rica insurance for minor things (annual physical and follow-up treatment if required.
    2) US medicare for more major issues (non-life threatening surgery and/or follow up treatment, surgery that is not required PDQ);
    3) CAJA for life threatening emergencies (heart attack, accidents, stroke, shark or snake bite more likely depending on where you live, vaccinations, minor problems; )Note that many Expats use CAJA to provide their Rx’s if written by a private physician that is also affiliated with CAJA.

    CAJA facilities and care vary greatly throughout the country.

    Not all private insurance companies will cover pre-existing conditions and some have a maximum age limit.

    #173685
    VictoriaT
    Member

    My husband and I both have Medicare part A because it’s free. When I needed shoulder surgery, we debated returning to the US and going the Medicare route. Medicare would have covered 80% of the cost. Factor in airfare, hotel, meals and other things not covered by part A and the cost was over $15,000. So we went to CIMA where they did the surgery for $6,500.

    Medicare? Nah!

    #173686
    Imxploring
    Participant

    A torn rotator cuff or labrum that can wait a bit is a lot different than a life threatening illness or injury. Had your situation been cancer would the expense of traveling to the US been an issue? Keeping Medicare (beyond the free portion) and signing up when eligible is a no brainer. The monthly cost (and avoiding the penalty for delaying signing up) is a back up plan worth having!

    When you have Saudi Kings coming to the US for important surgical treatment and medical care that should tell you something.

    #173687
    VictoriaT
    Member

    I agree IM. I was having bone spur and debris removal. However, I have friends who are being treated for cancer here in CR, but at CIMA, not CAJA. For that emergency, CAJA comes in handy but even when we were in a car accident, I elected to go to CIMA. The CAJA hospital the took me to first had corridors lined with gurneys full of people. I decided I didn’t have to fill another gurney when I could afford to go to CIMA.

    #173688

    Sir, I did not think of it when I replied to you in September. But Sir, are you or a wife a US military veteran? If you are, honorably discharged, even it you have not militarily related injuries, I would try to get into the Veterans Administration medical system. I was in it in Portland Oregon for a decade and when it was time to sign up for Medicare, they had me only sign up for the non-premium part A. If you come here and only have part A, then when you return to the USA you have to prove to them you have had insurance here in Costa Rica. Meanings you will have to save either your private insurance or if you get residency, the CAJA, all your monthly receipts to prove to Medicare you have had insurance after your 65th birthday. But with the VA, once in the system, always in the system. You can always call them from here and get appointments with them when you return the USA for visits. Just a thought for consideration if you are a vet.

    #173689
    costaricafinca
    Participant

    I understood that you couldn’t claim your CAJA coverage as ‘insurance’ when out of the US…as it isn’t considered ‘insurance’ but the socialized health care system of Costa Rica.
    Of course, I could be wrong 😯

    #173690
    Imxploring
    Participant

    [quote=”costaricafinca”]I understood that you couldn’t claim your CAJA coverage as ‘insurance’ when out of the US…as it isn’t considered ‘insurance’ but the socialized health care system of Costa Rica.
    Of course, I could be wrong :shock:[/quote]

    The same can be said about Medicare…. the difference of course is with Medicare you’re forced to pay into it for 45 years before you can claim your coverage…. if you live that long! LOL

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