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This is an extract. Please read the entire policy to get the full picture. Following are the coverages available. Within certain rules, you can select the coverages you need and pay for the ones you get.

Extract

WHO CAN BE INSURED?

Residents of Costa Rica ages 18 to 65 can apply. Application from persons up to 70 have sometimes been accepted. INS will renew indefinitely so long as premium is paid. Dependents from birth up to age 24 can also be insured.

WHAT IS COVERED?

Medical expenses due to accident, sickness or maternity, up to $2,000,000 per year. For persons over 69, coverage is reduced to $600,000 per year. The policy will also pay for a yearly eye test and checkup, as of the second year. Covers hospital and ambulatory care. Subject to sub-limits, maternity, cancer, epidemic diseases, prosthesis, transplants, ophthalmic care, air ambulance if medically required, repatriation of remains, death benefit for burial, etc

WHERE?

Worldwide coverage.

MAIN EXCLUSIONS

Conditions existing when the insurance is bought. Treatments for obesity, cosmetic surgery, sterility, congenital conditions, dental care, sex change, insemination, mental disease, addictions, attempted suicide, self inflicted lesions, pregnancy of dependents except spouse, accidents when the insured was under the influence of drugs or alcohol, correction of vision, treatment for AIDS and HIV positive, erectile disfunction, chiropractic and podiatrists’ care, tranquilizers, antidepressants, vitamins, non-prescribed expenses, experimental treatments, accidents while practicing high risk or speed sports, medical expenses as a result of cataclysmic events, terrorism, civil insurrection or war.

PRE-EXISTING CONDITIONS

At the discretion of INS, these can be covered if the applicant has had no symptoms in the two years before an application is submitted.

CLAIMS AND DEDUCTIBLES

In Central and North America there is a network of providers (doctors, hospitals, labs, clinics and pharmacies) where you will pay less because they are bound to a price list imposed by INS - and you will get a lower deductible. Also, you use your insurance card to cover the balance for hospital care. (You can also get this insurance with a blanket, per year deductible, where you accumulate your medical expenses and, if in the policy year they exceed the limit, you can claim for the excess.) 

With preferred providers, for hospital care you pay for one day of hospital room, plus 10% of the following $5,000; for ambulatory care you pay $10 per doctors’ visit, plus 10% of other prescribed expenses.

With outside providers, for hospital care you will pay for one day of hospital room with a minimum of $200, plus 20% of the next $20,000; for ambulatory care, you will pay $20 per doctors’ visit, plus 20% of other prescribed expenses.

HOW MUCH DOES IT COST?  

Examples of typical yearly premiums:

Large Individual Deductibles
Standard Deductible
Minimum Deductible
US$ 5.000
 
Age
Gents
Ladies
Gents
Ladies
   
26-29
1,043
1,254
539
634
   
35-39
1,332
1,622
674
803
   
45-49
1,715
1,921
863
951
   
55-59
2,199
2,425
1,116
1,206
   
65-69
3,331
3,279
1,720
1,668
   

Minimum Deductible
US$10.000
Minimum Deductible
US$ 15.000
 
Age
Gents
Ladies
Gents
Ladies
   
26-29
402
463
323
365
   
35-39
495
580
392
451
   
45-49
630
684
493
530
   
55-59
819
873
647
680
   
65-69
1,279
1,226
1,023
972
   

APPLICATIONS

No medical examination is normally necessary. For bureaucratic reasons, policy applications are best filled out by an Agent. You must pay the first premium at the time of applying. Policy comes into effect 30 days later. Some  medical conditions have a 10 month moratorium.

4/06  

 
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