ALTERNATIVES TO “INS” MEDICAL INSURANCE

The fact that INS is the only insurance company in Costa Rica does not mean that the INS medical insurance is the only coverage available. Other sources of Medical coverage are:

THE INTERNET. Since the popularisation of the Internet there are various Medical insurance options available “on line”. If you decide to go through the Internet, make sure you deal with a recognised, reputable insurance company.

PRIVATE “NON-INSURANCE” PLANS. In recent years there have been several options offered by CIMA and Clínica Bíblica which do not violate INS’s monopoly as they are somewhat unlike insurance. With these plans, the subscriber invests X amount per month and builds up a fund upon which he may draw when he needs medical care. If the cost of the required care exceeds the amount accumulated in the fund, the organizing hospital will advance the difference but the subscriber must come up with guarantees. These funds are unregulated and do not accrue interest to the subscriber, so what we are really looking at is a mechanism whereby persons who are unable to save money and create their own fund abdicate this burden and, in payment, the organizer earns the accrued interest.

The plans currently being offered are organized by very reputable hospitals. However, in the past some of the companies offering similar plans have disappeared and left their subscribers high and dry. In the early 80’s there was Hospital Ibero Americano. In the late 90’s, Medi-Pre.

The main drawback of these plans is that treatments can only be administered by and in the organizing hospital – in the Central Valley of Costa Rica.

TRAVEL POLICIES. Sometimes people need medical insurance for short periods, and often they need it ASAP, right away. INS’s full blown Medical policies all take 4-6 weeks to get in place, so often the problem is solved by means of Travel Insurance policies, which provide some major emergency medical coverage.

COSTA RICAN SOCIAL SECURITY. "La Caja" provides health care directly, so this is not really insurance. Some people use La Caja as a primary care provider, but a lot of people use “Caja” coverage as a supplement in case one of the smaller INS policies were to become exhausted by a large claim, or in case the insured person were to develop an ailment excluded by INS.

La Caja Costarricense del Seguro Social (its official name) was created to provide medical care to Costa Rican employees and their dependants. All employers have the obligation to enrol their employees. The monthly cost is borne by employer and also by the employee by means of a payroll deduction. La Caja acquits its obligations providing service through a series of large, well equipped, overstaffed and often inefficient hospitals – but, in all fairness, it must be pointed out that Costa Rica has an enviably high life expectancy – largely due to the universal birth-to-death care provided by La Caja.

Costa Ricans and legal residents can obtain Caja coverage even if they are not employees, or are self-employed. Most foreigners who want this coverage obtain it through the Association of Residents of Costa Rica “ARCR”, which has negotiated a special rate for its members. Through the ARCR, the cost is $58 per month for heads of family under 55, and $37 per month for those over 55.