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Health and Medical Insurance in Costa Rica

The Instituto Nacional de Seguros (INS) was for years pretty much your only option for insurance and was, in reality, a monopoly. The signing of the Central American Free Trade Agreement eliminated monopolies and now there are options for various types of insurance.

INS offers various types of insurance, including life, health, home owners, renters etc. The group plan offered by the Association of Residents of Costa Rica can be a money saver. Health insurance from INS does not cover pre-existing conditions or check ups.

Here are the current discounted rates offered by the ARCR 2015 group plan. Rates can and will change at any time.

 MEN  WOMEN
 $400.000,00  $400.000,00
AGE  INDIVIDUAL PREMIUM  ARCR PREMIUM  YOU´LL SAVE  INDIVIDUAL PREMIUM  ARCR PREMIUM  YOU´LL SAVE
35-39  $  1.222,00  $1.041,00  $ 181,00  $  1.491,00  $1.232,00  $259,00
40-44  $  1.320,00  $1.111,00  $ 209,00  $  1.643,00  $1.341,00  $302,00
45-49  $  1.576,00  $ 1.293,00  $ 283,00  $  1.765,00  $1.430,00  $335,00
50-54  $  1.809,00  $1.459,00  $350,00  $  2.056,00  $1.636,00  $420,00
55-59  $  2.022,00  $ 1.612,00  $410,00  $  2.231,00  $1.760,00  $471,00
60-64  $  2.549,00  $1.988,00  $561,00  $  2.578,00  $2.008,00  $570,00
65-69  $  3.067,00  $2.359,00  $708,00  $  3.018,00  $2.322,00  $696,00
70-75  $  3.938,00  $2.980,00  $ 958,00  $  3.854,00  $2.925,00  $929,00
76-80  $  5.526,00  $4.176,00  $.350,00  $  5.216,00  $3.950,00  $1.266,00
80+  $  7.737,00  $5.937,00  $1.800,00  $  7.303,00  $5.623,00  $1.680,00

Blue Cross

Blue Cross is now available in Costa Rica. Check their web site HERE.

Ex-Pat insurers

There are also a large number of insurance carriers specializing in ex-pat health policies. One of these is BUPA (this is NOT an endorsement and is placed here only as an example and I kinda like the name,), but there are many others.  Do a web search for ex-pat health insurance to get the big list.

I cannot stress enough the need for good coverage. Many insurance agents specialize in ex pat coverage or simply coverage for those who travel internationally. Check them out and ask for recommendations.

Socialized medicine (like CAJA) is maybe less expansive but there are issues. You may have to wait months or even years for certain procedures, i.e. cataract surgery, joint replacement, etc. This is the drawback with any socialized medicine. That is why many people have supplementary policies in those countries that have socialized medicine

In any case, you DO have options!

As with ANY insurance policy, always check for important provisions such as pre-existing conditions, age limits, cancellation policy and so on.

CCSS – Caja Costarricense de Seguro Social

(Caja Costarricense de Seguro Social) This is the government medical plan that many Costa Ricans have. It is socialized medicine, so be prepared! It works very well for low income groups, and you will get decent medical care, but lines are long, medicines are generic and may not work well, and as with all socialized medicine, you can wait years for some forms of surgery or treatments.

First: If you do not have legal residency, you may not join the Costa Rica CAJA plans. Even if you do, buying a separate health insurance policy other than CAJA is an excellent idea. Here is a catch-22 thing. You may not be a legal resident without having CAJA and you cannot get CAJA unless you are a legal resident. Sounds tricky, but it’s not. You will learn about this when applying for your residency.

The CCSS plan covers pre-existing conditions, doctor visits, prescription drugs, examinations, hospitalization, dental and eyes. There is no limit on annual amounts paid out by the plan. A doctor and clinic is assigned to the patient. Lines and the processes can be very long and waits of several months for some appointments are common.

AGAIN: CAJA is REQUIRED of all who seek legal residency here in Costa Rica. You may not obtain any form of residency without proof of CAJA coverage.

CAJA used to be very inexpensive. Not any more. Do your homework on this before you start your residency.

CAJA hospitals (there are about 28 located around the country) are open to ALL, whether you are a member of CAJA or not. You just have to pay!

 

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