Retiring in Costa Rica, Insurance thru “Caja”

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Can I buy the Public Health care Insurance better know as the “Caja?”  I am planning to retire in Costa Rica.  I have heard that this insurance is good and not expensive.  Is this truth or fantasy? 

Yes if you become a permanent resident of Costa Rica you are required to purchase the Government run public health care insurance.  The cost depends on your annual income and if your income is high the Insurance is not inexpensive. The delivery of the Caja health care in this system is the PROBLEM.   Simple illness are treated in rural health care clinics located in each neighborhood.  But if you need surgery you will have to wait in line. And I mean along time. Here is a good example.  My  adult adopted daughter lives in a suburb of Alajuela.  She is insured thru the Caja.  Simple illness are taken care of at the rural health clinic 5 miles from her home. She gets up very early in the am to make the line at the clinic which is usually 1 hour wait.  If medication is prescribed she has to make a a second trip to pick up the medication which is sent to the clinic hopefully that afternoon between 2.30pm and 3 pm . If you do not show up in that 30 minute window -you do not get your medication.  You have to return another designated time to pick it up.  Or she can make a long trip into Alajuela to the general dispensary and get the medication.

Another story:  She has a torn rotator cuff in her left shoulder.  The Caja doctor referred her to a rheumatologist and is told her appointment is 9 months from now.  She takes her own money and pays a private rheumatologist  to evaluate her problem.  He tells her she needs surgery to correct the problem.  And this is where the real trouble begins. He was unable to refer her within the Caja system to a specialist for this surgery.  Why? No surgeon who specializes in this type of surgery  is on the Caja roster.  Now we are seeking a doctor  in private practice  with the experience and credentials to perform this procedure .  She will have to pay out of her own pocket for everything!  “Caja” failed her!!

So I am telling you.  Simple illness-yes you can go to the doctor at the rural health care clinic.  HOWEVER for surgery you will be placed on a long wait..sometimes up to one year!  And super specialized procedures-well sometimes there is no Caja surgeon qualified to do the work. So you end up having to pay a private doctor.  The fees for private doctors are slightly less than in US however,  sometimes the fees are the same as in the US.

An option is to purchase private health insurance policy- sold here in Costa Rica.  Some of them are good.  However you still have to pay monthly the Gov insurance to the Caja.  So you will pay double.  Unfair?  In my opinion yes this is unfair!

Ann has lived and worked in tourism in Costa Rica for many years.  She was married to a Costa Rican -thus living in the true Costa Rican culture.  That is the reason she is eye witness to how the Caja really works.

Questions? email Ann     anncreed23@gmail.com

Read about Ann on her website     www.costaricalearn.com

 

 

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