From Live in Costa Rica Blog – Over the years I have many clients on my monthly relocation/retirement tours with health care issues. Some were in their late 50s and were willing to come to Costa Rica because they could not afford the cost of medical insurance in the U.S. They preferred to live here and “pay out of pocket” until they were eligible for Medicare.
I
even had a retired doctor on one tour who was looking at Costa Rica because he said he could no longer afford to pay his health care premium in the U.S.
Recently, a friend who resides in the States wrote me saying that she had just experienced a $400 increase in her insurance under the Obama’s plan.
Obama Care, officially called the Patient Protection and Affordable Care Act, is a healthcare reform law law signed in 2010 By President Barack Obama. Many of the law’s provisions are already in effect and the rest continue to roll out until 2022. Important provisions include a mandate for most Americans to have insurance by 2014 and the opening o health insurance marketplaces for subsidized insurance. For more information see: http://obamacarefacts.com/obamacare-explained.php
Seniors will receive some benefits under the Obama plan, but some of the reforms to Medicare include reductions to Medicare Advantage, home health care payments and Medicare hospital payments. We’ll have to see how all of this plays out I the long run.
There are a lot of pros and cons about this program that you can read about on line. Recently, I noticed that some of my tour guests are disgruntled by the Obama plan and are looking at Costa Rica’s health care system as a possible alternative. You have to be a legal resident of Costa rica to be able to join the Caja or country’s public health care system. In theory you pay about ten percent of your monthly pension which gives you complete coverage including pre-existing conditions. I have heard some retirees rave about the caja while others are critical of the services it provides. However, I have heard about more good experiences than bad ones.
In Costa Rica you also have the option of private insurance plans like the one provided by the INS or National Insurance Institute. Basically it cover about 80 percent of all expenses but does not include pre-existing conditions. The plan has a $400,000 ceiling which is a lot of coverage considering the low cost of medical care here. There may be a few other stipulations as I recall. One advantage to this plan is that you can choose your own doctor and not have one assigned to you as in the caja system.
The other alternative is to pay out of pocket as some retirees, expats and Costa Ricans, who can afford to, do.
The country’s great weather and health care options mentioned above are two of the main reasons people choose to retire here.
Most who complain about the ACA don’t understand it. One major benefit, especially for people with many medical needs, is that it covers pre-existing conditions and does not permit insurers to increase premiums for those whose medical expenses are high. The INS policy discussed here, on the other hand, does not cover pre-existing conditions, and INS will increase your premium based on your claims history. I had the INS policy for years until I had to let it lapse last year because INS increased my premium by 600% (no, that isn’t a typo). When I had it, I had constant hassles with INS not covering charges due to documentation technicalities. Of course, we have the caja, but it doesn’t come any cheaper than the ACA for those on low incomes, doesn’t allow you to pick your doctors (and your doctor will probably require for you to speak Spanish), and doesn’t cover many medications that your US doctors may consider necessary (in fact, those meds may not even be available in CR). Anyone considering choice of coverage in the US and that in CR should research the options thoroughly, starting with getting the real facts (as opposed to the Republican spin) about the ACA.
One of the benefits we perceived when moving to CR was the Caja. Unfortunately, it has been a major disappointment. It isn’t so much the cost, which continues to increase at a high rate, but for the most part it is just unusable unless you have a life-threatening illness or emergency. Even for Ticos, services are severely rationed. It is not uncommon at all for patients to have to wait 5 years for a knee operation for instance. Yes, the do not take into account preexisting conditions but they do raise premiums based on age. Some people are paying close to $200/month for an almost unusable system. Fortunately, private care is accessible and very affordable. It still beats what would be available for our family under the ACA, even though it is a tremendous improvement of the U.S. health care system.