In a recent post, I said that I would provide some information regarding the differences in the two healthcare programs in Costa Rica. Now, I can tell you that I am not anywhere near an expert on this subject. Below, is what I know and have experienced.Please see below..
National Healthcare Insurance of Costa Rica
The National Insurance of Costa Rica is called the CAJA. As far as I know, you must have a residency in order to join. This is the program that all citizens of Costa Rica are covered under. The rates vary based on income, but the best place to get it is through the ARCR (an expat organization based in San Jose) Through the ARCR, our monthly premiums are about $50 per month. This includes complete coverage on medical, dental, hospital care and prescriptions. There is no co-pay, and my pre-existing conditions were not a factor.
This program has its pro’s and con’s as any other National Healthcare Program would have. Some of the cons are that sometimes it takes a very long time to get some necessary testing and procedures done, and all of the prescriptions are generic. The pros are that: If you have an emergency need, there is no one better qualified to help you. Once you start going to the local clinic and seeing a doctor, they will test you every 6 months and make sure you have the drugs that are necessary to maintain your health. From my last test, they found that I had diverticulitis and made sure that I was put on a daily fiber supplement program.
The CAJA hospitals are very good, and you don’t have to wait forever to get in for your appointment. The one I usually go to is the Hospital of Mexico located close to San Jose. My last trip was to get a bone scan. I was in and out in about ½ hour and the equipment was identical to that of my bone doctor’s in Nashville, TN. According to what I have heard, this hospital is also considered one of the best for cancer treatment.
Private Insurance
The main company for private insurance is INS (Instituto Nacional de Seguros.) There are other companies around, but this is the main one. The private insurance companies are very similar to those in the US, but much less expensive. They have a very good program to supplement the CAJA. Here you have a choice of doctors and hospitals to choose from. Their coverage is very good, and if you want to use a private hospital like CIMA, then this may be a program to do some more research on. The costs vary depending on your medical records. Stef opted for this additional insurance and her annual cost is around $1,200. I would expect mine to be somewhere just under $2,000. The way her program works is that she pays for the prescriptions and other care up front. She provides the receipts and is immediately reimbursed.
My Personal Program and a Recent Experience
So far, I have been extremely happy with the CAJA. The doctor I see is very highly qualified and always willing to help me with my needs. I was also very happy with my experience at the Hospital of Mexico. Because of this and the low cost of medical care in Costa Rica, I choose to just take the CAJA program and pay cash for the other if needed.
Recently, I had to have some polyps removed from my colon. The doctor I was working with regarding this condition told me that it would take 6 months to get into a CAJA facility to get the procedure done. Because all my friends were on my case to get it done, I opted to go to a private clinic for the procedure where I would have to pay cash. It was done at a price of $1,300 including the biopsy lab work on the polyps that were removed. The way I looked at it was that this was cheaper than paying the annual premium for the Private Insurance. – Now, I don’t know how much something like this would have cost in the US, but I will bet money, it was one heck of a lot cheaper.
That is about all I can tell you about the insurance programs in Costa Rica. Hope it helps.
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