Medicare & Medicaid

This is an update to an earlier post…….12/19/2007

After verifying information that I recently received, I learned that Medicare will not cover anyone living outside of the United States.  Same story for Medicaid,  you will NOT be covered while living in Costa Rica.

IF you have a medical emergency while you are visiting Costa Rica or while living in Costa Rica, Medicare/Medicaid will pay for Air Transportation for you to be flown to the closest hospital in the US, but they will NOT pay for your treatment while in Costa Rica, even in an emergency situation.

This also includes those on disability relying on Medicaid.  You must go to the US for medical treatment.  Any doctors visits or medical attention of any kind will not be covered by Medicaid.



Medical Care In Costa Rica

Costa Rica is becoming the mecca for North Americans and others who need reasonable health care. The president of Costa Rica has put out the welcome map for foreigners who want to come here to take advantage of the lower-cost medical care.

The president, Nobel-Peace Prize winner Óscar Arias Sánchez, issued a formal decree to assist those local clinics, medical professionals and the foreigners who wish to come here.

Among other actions, the president said the country would promote international accreditation of hospitals and clinics which specialize in foreign patients. Already Costa Rica has hospitals that are highly respected. One even is associated with Southern Methodist University.

Accreditation will give visitors a guarantee that highly trained professionals from elsewhere have studied the education, facilities, practices and philosophies of those organizations offering health care.

Arias already has told the educational ministry to make sure high school graduates are functional in English within a few years. That goes double for the health professions, because many physicians, dentists and nurses have studied in the United States, Canada and Great Britain.

Arias also said that his government would work with foreign insurance providers to make certain that medical care here will be covered by  companies in the home country.

In 2007 some 8,500 foreigners, mostly U.S. citizens, came to Costa Rica for health care. Costa Rica has a dynamic system covering most of its citizens, and many practitioners share their time between private and public hospitals and clinics. So they have the advantages of both.

Why is health care so reasonable here? A lot has to do with the bureaucracy of the U.S. system. Some sources estimated that fully 40 percent of the money spent on medical care in the United states goes to administration.  Costa Rica is a country that is not known for its high insurance rates on medical professional. Plus the overall cost of living is much lower.

Costa Rica is convenient and just a few hours by air from most of the United states. And as a recovery spot nothing can beat the great climate, the great service and the many possibilities a medical vacationer can find in Costa Rica.


Medical Care in Costa Rica

US and Costa Rican medical tourism agency Health Choices International has developed answers to perennial questions they are asked by potential customers.

There are three principle reasons why individuals from a developed nation would travel to Costa Rica for healthcare.

1. Affordability – For many, healthcare at home is too expensive.
Costa Rica has cost savings of 40%-80% of US prices.

2. Accessibility – The medical treatment needed is not available in their home country or the waiting list is too long. Individuals are simply not eligible for certain medical treatments due to age or health limitations – hidden medical rationing. In other circumstances the medical treatments are simply not available due to cost. Costa Rica has none of these problems.

3 Quality. The boom in high-quality healthcare providers internationally, primarily in less-developed countries, has made treatment overseas at the same quality as at home, easily available.

Costa Rica has quickly become one of the top medical tourism destinations in the world for cosmetic surgery, dentistry or operations such as hip and knee replacement,

Costa Rica’s healthcare system is very advanced and is considered one of the best in Latin America. For some procedures, it ranks higher than the US.


Medicare in Costa Rica

Here in Costa Rica, we received an early Christmas present this year when the news came out that Medicare has begun providing their services to Americans in Costa Rica. There are many details to work out, but they have started covering people from Southern California and expect to cover everyone from the States within 3-4 months for urgent procedures in Costa Rica.

This is great news for everyone who has fallen in love with this country because even if you are below 65, the system will be in place when you need it.

I’d like to point out that as far as I know this is the first country that US Medicare will be available in – not even Canada. I believe this shows that they understand how many Americans want to be here (and there has been a US Social Security office here for at least 15 years).

This also reflects that the quality of health care offered here in CR meets the standards of US Medicare.



Dental Cost

If you haven’t heard already, Costa Rica is the place to come for dental work. The prices here are so reasonable you can pay your airfare and hotel and still come out cheaper than you would in the US.

Today I took one of my children to the dentist for 2 fillings and to have a tooth pulled. Total bill was less than $80.00. Yes that is $80.00 US and it even included the local anethesia. I think the last time I paid to have a tooth filled in NY it was well over $200.00 for one tooth and that was several years ago.

One of our friends is having braces put in and was complaining that it costs so much. Nosey me I asked how much is it costing you? The response almost had me falling out of my chair. He’s paying $50.00 per month for a grand total of $1,200.00 US. I quickly told him of another friend in the US that was considering having braces done here because it is going to cost $8,000.00 at her dentist in the US. He thought maybe he was getting off cheap after that conversation and probably won’t complain as much about how expensive it is here.

I recently had to have a root canal and porcelin crown on a molar. The grand total for my bill was only $500.00.

If you considering having major work done, there are several very well qualified, often educated in the US dentists here that will do the same work for a fraction of the cost in the US.

Should we ever leave Costa Rica, we will come back to have all of our dental work done. One of my children is going to need braces and you can’t do it any cheaper than you can here. It’s worth the trip and you get to see a little of paradise while your here.


Our Service

You should know that while you will get a lot of basic information from this blog and from our website, this is in no way a complete assessment of the topic being discussed. We only touch on the subjects that we think would be of interest to someone considering moving to Costa Rica.

Many of the topics that I choose to write about come from questions presented to me by clients. Others are news that’s happening in Costa Rica.

Some things I write about seem kinda fuzzy, immigration for instance.  When the laws are as confusing as they are, I can’t help but sounding a little confused myself on some of the details.

We do know what we are doing when it comes to relocation. Make no mistake about that.  Our service is a paid service and you get what you pay for when it comes to relocation services.  As I said, many of the topics we just touch on but when you come down as one of our clients you learn all the ins and outs of living in Costa Rica.

You will meet attorneys that give you legal advice and assistance on residency, insurance agents that know all about insurance.  We hook you up with the professionals to handle the things that we are not well versed in.

You can learn in one week what it would take you months to learn by working with my company.  If you don’t believe me, read some of our testimonials on our website or ask for references.


International Insurance

There are several international insurance carriers that offer far more robust health insurance policies than INS.  Some have lifetime limits of $5 million and they will pay no matter what country you are in when the expenses are incurred.  Some even have reduced premiums if you specify that expenses will ONLY be incurred in one country or in Central America.

Note:  While you cannot buy health insurance in Costa Rica from any other company than INS or CCSS, these other policies are perfectly legal to purchase and many have payment arrangements already in place with several private hospitals in Costa Rica. This is one way to get around one of the great monopolies of Costa Rica-INS.

You can do some research on this by Internet or contact Guardian Angels at for some of your options with International coverage.


CCSS-Caja Costarricense de Seguro Social

An alternative to the INS plan is the CCSS plan. (Caja Costarricense de Seguro Social) This is the government medical plan that most Costa Ricans have. The 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 long, but you will get decent care!

The cost is very reasonable – about $37.00 per month for a family where the principal insured person is over 55 years of age, and $58.00 per month where the principal insured is under the age of 55. For those under 55 there is a compulsory pension fund payment in the premium. Family includes spouse and dependants under the age of 18 years. The prices quoted are from 2004 and have likely gone up slightly.

Insurance through CCSS Requires Costa Rican Residency.

You CAN have both INS and CCSS!  Many people have both.

Also, many doctors in the private hospitals are CCSS physicians and can often arrange billing through CCSS.


Farmers Markets

In almost every town or neighborhood there is a weekly farmers market. Offered up are mounds of onions and peppers, whole hands of bananas and row upon row of lettuce. Quality is often better and prices lower than in the supermarkets. It’s also a lot more satisfying than choosing from among plastic-wrapped cucumbers at the local supermarket. You probably won’t find organic products as they are still a novelty but it’s been seen as of late in some of the markets.

The markets are social occasions, with housewives chatting with neighbors or with vendors they’ve come to know. Cheese, meats, and fresh juices are often available as are plants, from daisies to orchids. Arrive early in the morning for the best selection and bring your own bags or cart as they don’t have them there.