Health coverage/insurance questions

My apologies in advance if these questions have been asked before....but I looked in the threads and could not find anything under 2 years old and not specifically for what I am trying to find.

Wonder if someone could help me? 

I am an american citizen, under the age of 60 and have a chronic illness that has made me disabled (still working through the SSD system - but not approved).  My group PPO medical plan through my past employer expires at the end of this year and I need to figure out where to move where I can still get quality medical care, but not too expensive.  So, hoping someone can let me know if Costa Rica would be a good choice for me.

From doing online research, I am seeing that CR has basically 2 plans: 1) caja, 2) INS.  I am sure there are global or country specific insurance plans, but I have been turned down by all of them due to the pre-existing condition.  So, my understanding is that caja is part of the CCSS and the monthly cost is about 10% of your income.  Is that correct?  But the cost does include a small pension benefit after a certain age? 

Then on INS, it seems the facilities and quality of care may be better than caja, but I cannot find out how much it is online.  I don't speak Spanish yet, but I will learn soon so that I can call an agency.

That said, once I am able to work through restista, are both options available to me with a pre-existing condition?  Or do you do a combination of both?

Really appreciate any input. 

Below is the link where I am getting some of my information, but not sure how accurate or if I am able to get treated with a pre-existing condition.

W-II.......Get ready for a lot of cross information ! You have a lot of sorting out to do.It sounds like your probing and have never even been here on a vacation.Before you put your eggs in one basket,just come down and take it easy here for awhile.Eventually,with time you'll find out if Costa Rica is even worth it.To come to a country where you know nothing about the culture,language or have no roots or history,is going to be quite a ride just to get a believed discount.

Thanks for the response. Actually, I have been to Costa Rica. In fact, I have been to 46 countries. I don't really like San Jose, but was considering Jaco or farther north.

I am currently near the Mexican border and can't get across because I forgot my darn vaccine card and the consulate is closed. So, it isn't Costa Rica is my only choice. It is just that I am running out of time and countries that will have a consulate open and I can travel to. Philippines, Malaysia, Laos, Vietnam, etc still won't let anyone in and all the consulates are closed.

W-II.......Costa Rica,will be a piece a cake for you then...Check out,San Isidro Del General/Perez Zeledon.There is accessibility to everything there,without the madness of San Jose.Colombia is very vogue now because it is way cheaper than Costa Rica.Sometimes you have to question the cheaper place,if it is even worth it,like Nicaragua.Nicaragua is no longer a draw because of the obvious..........

In  regards to receiving a small pension, one must have paid into it for years until you are 55, so sorry to say, you will not be eligible. to receive it.
Once you have been accepted for Rentista status, CAJA will cover all of your medical needs, however the wait time for an appointment for specialists can be very long. You cannot choose a particular doctor or medical facility, but must use the one in your immediate neighbourhood. Then, you will be referred to a specialist.
Unfortunately, you will not be aware of the cost of your monthly premium until your application for residency is complete....which will probably will take a year or more.

Why do you need the vax card? Costa Rica doesn't require neither this card nor so-called covid test, so you can fly. Unless you drive through countries that require it. You just need medical travel insurance, which you can purchase online and complete the travel pass online.

As of August 1 if you have a Vaccine card and been vaccinated over 14 days you will not need health insurance/health pass to enter CR

Correct. The latest change.

Thank you.

I am not concerned about the pension benefit.  Just focusing on the medical part.  That said, I completely understand about the waiting for Dr's, etc.  But pre-existing conditions are ok?  And can I combine the caja with INS?  My understanding is that caja national is not as good as having INS and going to somewhat private dr's and facilities. 

As for the costs, I believe caja is approximately 10% of your monthly income.  A little to personal to share here, but that equates to over $800 a month for me.  That seems to be very expensive for what you get on caja.  Now, for INS, since it is still an insurance company (sponsored by government?), I think the monthly is cheaper, get to go to privately owned facilities and monthly premium is about $300.  And they do not go by how much you make. 

On the timing of things, I really need to work out the costs and type of medical I need before going through the whole rentista process.  A full year until I know is something I cannot do.  Especially since I won't be able to go to a Dr within that time and paying to live in both the USA and CR.

Thanks :)

I noted I was on the border of mexico when I wrote the post.  I was trying to get from San Diego to Ensenda to talk with Dr's and Pharmcists to understand how mexico worked.  The consulate is closed and they are not responding on whatapp (for mexico).

So, now I am looking at Costa Rica.  And yes - I can travel there - but I would rather try to understand how the medical system works first and costs beforehand. 


Preexisting conditions is not a problem or concern when affiliated with CAJA. When applying for Rentista status, the $2,500 that is automatically transferred each month is your 'living expense account'...

Presently, when applying as a Rentista one would deposit $60k when you initially apply, then two years later a second $60k is required to be deposited. At the beginning of your third year, you can apply for Permanent residency, and when that has happened, then you would then be required every few years to obtain a replacement cedula, at a cost of $123.

Since there are expected changes to take place soon, I an uncomfortable when providing information at this time as how they are their previous 'rules' are expected to proceed.

I do know of 2 '30'something' Canadian military couples that paid a premium of just under US$800, when applying as Pensionados plus they also purchased private insurance to get faster treatment  at a private hospital. Both couples returned to Canada...

As previously mentioned, I expect you will have to wait for an extended time to be covered by CAJA. How long it will take, is anyone's guess.

I would suggest that you wait for approval by SSD  then apply for Pensionado status, and would only required a pension of at least $1000  month....although it is not enough to live on, in my personal opinion.

Thank you.  Ugh.  None of that is good news. 

Maybe CR is not going to work then.  It sounds like a long process and very costly on a monthly basis (double or triple that of the USA on medical costs).

As for SSD - you already know how long that takes.  I am in the 1st year of the process and probable another 2 to 3 years to go.  I was planning on working on this while living elsewhere. 

Thank you again for the clarification.  Now I have to try another country....

All three temporary resident categories (pensionado, rentista and “investor” (however that's spelled)) require that you enroll in and pay for the CAJA. It's not an option. You don't have to actually use the CAJA's services and facilities, but ya gotta pay for ‘em.

A note about SSD: your current receipt of monthly benefits under the U.S´ Social Security Disability Insurance program may not meet the income requirement for pensionado temporary residency regardless of the amount of your monthly benefit. The problem is that SSDI qualification is always reviewable by Social Security, and if your health status has changed, or when you become old enough for Social Security Old Age Insurance, your SSDI benefit may be terminated. So SSDI really isn't the “lifetime guaranteed “ income that the pensionado temporary residency status demands.

It may  be difficult or impossible to get Social Security to issue a document that attests to your permanent disability even though your condition is,  in fact, medically permanent. They are very cautious about matters of permanent disability.

@daveandmarcia starts from $1300 per year and up, otherwise no residency.

We are Inversionistas and pay $47 USD a month for coverage for the two of us.

@TerrynViv the law doesn't work retroactively. This a new rule in place, which doesn't affect those, who got this caja before the this law. Hence you are ok but not new residents.

@daveandmarcia starts from $1300 per year and up, otherwise no residency.
[email protected]

Can you please clarify the above? What “. . . starts from $1,300 per year and up, . . .”?

Reported income $1150, and caja payment is 61,000 colones a month (jumped from 57,000 for me in one month), which amounts to 732,000 colones a year, or $1266 a year based on a current rate. Taking into account that caja payments are increasing regularly you get roughly $1300 or more. If your reported income is higher, you can figure...

@daveandmarcia For those who are interested:

December (first month) - 57,606

January - 61,477

February - 62, 550

It includes all possible taxes. Those, who got involved before this draconian law pay 3-4 times less.

I am still waiting for my Dimex residence card but this caja crap is being paid now. Ticos say that this caja is a total garbage.

We are paying for ticos health care.

Now, do your calculations. I plan to stop paying, give up my residence, return to border runs and then get out of here as soon as I'll sell my house. There are many reasons to leave this "pura vida" paradise.  I'll be missing ocean though.


My point was that when we enrolled in Caja the same things were being said. I spoke with a Canadian couple that had gone through their residency process and when they went to sign up for Caja their payment was to be $750 per month.  We had not yet qualified to apply for Caja and were worried we would have to abort our residency application due to the amount.  We followed through and our was and is $47 per month.  There is no all encompassing rule!  Everyone needs to find out for themselves.