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

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.



INS (Instituto Nacional de Seguros)

INS offers medical insurance.  There is a limit of about $17,500 per year, and it does not cover pre-existing conditions or check ups. Dental work, eyeglasses and cosmetic surgery are only paid if they are needed as the result of an accident. Claims are based on a table rating types of treatment administered. Costs vary with age and sex. This plan pays 70% of prescription drugs, examinations, doctor visits, hospitalization and treatment and 100% of surgeons’ and anesthetists’ fees. The patient is free to choose the doctor. Approximate annual premiums for men up to age 59 are $550, between ages 60 and 75 $1020. Dependants under 19 are about $245 per year. Women aged 19 to 59 would pay about $885 and between 60 and 75 $1,305.

NOTE: Currently, the annual benefit is only about $17,000. This seems very low, but $17,000 here spends a lot more than in the USA.  Currently however, intensive care in a private hospital runs about $3,000 per day.  At that rate, you can chew through your benefit pretty quickly.  There are several companies worldwide that sell health insurance policies that cover you anywhere in the world and are perfectly legal in Costa Rica.  Most have a $2 million limit and are not much more expensive than INS.


Traffic accidents

If you have a traffic accident in Costa Rica, leave the vehicles where they are and call both the Transito (Traffic Police, at 222-9330 or 222-9245) and the INS known as the insurance investigator at 800-800-8000.  Both of these officials will come, eventually, to the accident scene upon notification and file their reports.  Only after they do so can you legally move your vehicle.

This may cause great traffic back-ups but drivers are used to this type of obstacle and will find a way to get around you.  I’ve seen traffic up on sidewalks and driving at the edge of a very scary drop-off to get around an accident.  So don’t worry about blocking the road.  Stick to the rules or the alternative will make you crazy.  Remember my radio story?


Lost Radio Part 4

Well we are almost over the hump.  This week I got the new locks installed along with a new radio that I now take out every time I leave the car unattended.  Next week we are going for the paint job for the damage that was done by the bone head trying to jimmy my lock.  We are also going in for more security for the car.  We found out that unless there is an earthquake our alarm doesn’t go off, so what good does that do me.  This new alarm system will activate if someone tries to break my lock or my window.  Honestly I thought that I already had that but apparantly not.

Now I have this stack of receipts and legal documents (the sworn statement that I didn’t call INS when the car was broken into actually had to be signed by my lawyer, already gave one statement to the INS saying the same thing???) and another document that shows that I actually own the car…..all of this falls into the WHY catagory which I explained why I don’t go there.

So now my WONDERFUL Insurance Agent, Eric Morales is going to take all the documents and receipts to the INS for me so that I don’t have to go down and experience the frustration.  You gotta love him for that.  I have to write ANOTHER letter stating that it is ok for him to represent me and pick up the check for me but that we worry about next week after we get the final bills on the work done.

Apparantly lawyers here are used to all the paperwork because when I called Sergio (my lawyer) he knew exactly what I needed, this made my life much easier.  All I had to do was give him a few specifics then he ran with it and produced this legal size paper that looks official with all it’s stamps or timbres.

You must have good lawyers and good insurance agents that look out for your best interest or you can really get into trouble here but that is a subject for a different day.

I’m basking in the glory of this whole process almost being complete.  And I never asked WHY once.



I have hesitated to write about this because it sounds so silly but it is so true and a large part of my existance in Costa Rica.
It always happens that something occurs here in Costa Rica and you want to know WHY they do what they do.  I am and have always been a why person, even when it came to learning Spanish, I wanted to know WHY everything had to be male or female, why the word so had 8 letters in spanish and other such sillies as that.  Things arise everyday where I find myself wanting to ask WHY is something done this way or WHY did they do that.  This was such a part of my person living in the US where everything seemed to make sense or by asking WHY you could get logical reasoning for why something  was done the way it was.  Since living in Costa Rica I have learned that asking WHY can send me to an early grave.

My latest blog entry about my car radio would be a classic example of how many WHY’s come to mind when dealing with INS or the car repair folks. Why do I need to go a dozen different places to get my radio and locks replaced?  Why do I have to wait 1 1/2 hours in the 3rd place I have been for someone to look at my car and see that the radio really isn’t there?  Why do I have to go pick up the parts myself?  Why can’t someone else do this for me?  And so on…
I tell people when they move here to try to take the word WHY out of their vocabulary.  Even when someone explains WHY they do something or the way that they do it, it won’t make any sense to us Gringo’s as it would always be much easier if they would do it the way we did it in the states but they never do.

This was my first taste of Costa Rican culture shock.  I had to get over asking why all the time.  Now when I find myself thinking WHY I switch channels in my brain and say, that’s just the way it is, I don’t need an explanation because it won’t make sense to me anyway.

This may sound idiotic but it works.  I live a much more stressfree life by not asking WHY all the time.  I have resigned myself to it’s just the way they do things and move onto something else.

I could give you a dozen or so examples of how this comes up in our daily lives but if you live here for awhile you will see for yourself it’s much easier to live here if you don’t question WHY all the time.  If you start to question WHY something is the way it is….bite your lip and move onto another topic.  Trust me it is the only way to live happily in Paradise.


Lost Radio Part 3

Well I finally got an appointment to go to the INS shop in Curridibat on this past Saturday.  We had an appointment for 8:30 and got out at 10:00.  Not too bad but all they had to do was look at the car to see the damage that was done and in order for them to do this we had to go sit in a waiting room for an hour and a half.  They finally gave me the report of what was wrong with my car, several pages of stuff that makes absolutely no sense to me.

I’m supposed to go get the parts then take it to a shop to have them install them.  Door handles (locks) in one place, radio in another place.  AFTER all this work is done I have to present a document showing that I do infact own the car and another, filed with an attorney, stating why I did not call INS at the time of the incident which means another trip to the lawyers office.

I present these documents with all their legal stamps/timbres along with receipts for the work that was done to my car and the parts that I purchased, then I am supposed to get reimbursed the full amount I have paid less 10% deductable.

This requires ANOTHER trip to INS which I am hoping my insurance agent will go for me.  I have to write another letter stating that it is ok for him to go in my place to pick up the check.

Now we have to rent a car so that ours can be worked on for a few days.  First I have to take it to the body shop to see how long they are going to need to make room for us, then how long it will take to get it back.  This should be another fun filled week.

By the way, I found out that the way they punched out my lock is what they do when they are stealing cars.  They punch out the lock then hotwire the car.  I feel very uncomfortable leaving my car parked anywhere for fear of it getting stolen since the first half of an attempt has already been made.


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.