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Looking for a medical specialist in Costa Rica

Looking for a medical specialist in Costa RicaWhile we’re here in Costa Rica still waiting for our “cedulas de residencia” as “pensionados,” we’ve kept our MediCare in the States in force in case there is a real medical necessity. If something major required a return to our old home State, we would be covered. In addition, my wife’s and my MediCare supplemental policies include emergency medical coverage for the first 60 days each time we leave, so this feature renews each time we exit the States.

This international coverage doesn’t cover non-emergency doctor’s visits and un-prescribed drugs and we’ve also heard that it is difficult to get reimbursed for emergency care provided outside of the U.S. even when inside the 60-day window. This is due to the differences in the billing codes and the different types of care provided for similar afflictions, but in any case we do have a bit of a medical security blanket.

However, we have no coverage whatsoever once that 60 day period expires. It’s pretty simple and not too expensive to receive non-emergency, non-specialized medical attention when you need it. Just make an appointment or simply walk into a private physician’s office (“clinica”) or the local CAJA medical clinic (part of the Costa Rican national health system) and wait to be seen. Or if it’s something that you feel only requires a prescription drug, head to the nearest “farmacia” (pharmacy). Many, if not most, have a physician or the equivalent of a physician’s assistant on staff. They can examine you in a private room and prescribe a medication to, hopefully, cure your ills. Even the pharmacists in Costa Rica, like many European countries, have much more authority to dispense prescription drugs and medications over the counter if your malady merely requires a medicinal cure.

 

Emergency Clinic Perez Zeledon

Emergency Clinic and ambulance services Perez Zeledon

 

If it’s an after-hours minor emergency, scoot on over to the La Cruz Roja (Red Cross) station (there’s one in every town of any size in Costa Rica). You will get emergency care and pay for services on the spot or if it’s a bit more serious, they will stick you in an ambulance and deliver you, at your request to either the nearest regional CAJA hospital or to one of the private hospitals, in the Central Valley. If private, it’s probably Clinica Biblica in San Jose, or CIMA in Escazu. And, don’t be surprised if the ambulance ride there may be free. (As an aside, many communities with a sizable population of upscale Tico and ex-pat residents have a private ambulance subscription service with skilled EMT-type technician attendants to provide on-site medical triage and delivery. It’s a bit like having monthly emergency medical/ ambulance insurance.)

 

I think that if they know you are paying out-of-pocket, you may get priority attention

I think that if they know you are paying out-of-pocket, you may get priority attention

 

If you do not have insurance coverage and you get care at a CAJA hospital or at a private hospital, you will be expected to pay out-of-pocket for your care. Experienced ex-pats tend to avoid receiving care at many of the regional CAJA hospitals, believing the care to be superior at a private facility. The upside for care provided at any facility in Costa Rica is you’ll probably wind up paying much less for an uninsured stay or procedure than it would cost you in the States.

Honestly, I’m still a little fuzzy on how long it might take to receive specialized tests or procedures when prescribed at a CAJA facility if you are not part of the national CAJA medical system. I think that if they know you are paying out-of-pocket, you may get priority attention. I do know that if you are a part of CAJA, as you will be required to join once you acquire residency here, it is sometimes a very lengthy wait to get certain procedures and tests performed. The wait within CAJA can often be minimized if you have a physician in private practice who is also a part of the CAJA system. They can usually authorize to put you at the front or near the front of the queue for many of these procedures and tests. While this practice called “biombo” is strictly illegal, it has been around for years, engrained in the medical culture, and may be arranged for you. Your wait can also be reduced if you opt for private medical coverage, either insured or uninsured, in addition to the required CAJA participation and get your medical care from a private medical facility.

 

They can usually authorize to put you at the front or near the front of the queue

They can usually authorize to put you at the front or near the front of the queue

 

What happens if you have a serious, or possibly serious, medical situation that requires a specialist and you have no medical insurance and no family practice physician to advise you or direct you to help? Well, this situation happened to me recently. I immediately hit the Internet to get an idea of what might be my problem and how much to worry about it. After I had an idea of the different things that my symptom might indicate, I knew that I needed to get to a doctor ASAP. In order to communicate my problem accurately, I knew my lack of Spanish, especially anatomical Spanish, would require being seen by an English-speaking physician-specialist.

 

I knew my lack of Spanish would require being seen by an English-speaking physician-specialist in Costa Rica

I knew my lack of Spanish would require being seen by an English-speaking physician-specialist

 

I had no experience with specialty medical care in Costa Rica and I contacted friends for recommendations of English-speaking physicians that might be able to help me. And of course, my symptom had presented itself on a Friday night. The first physician I contacted on Saturday morning via email was a specialist that practiced at CIMA. When I did not hear back from him by Monday morning, I went with Plan B and called a GP in the next town that also had a lab.

Hey, I didn’t say getting specialized medical services in Costa Rica was a slam dunk. My saga continues in next-week’s blog. Happy Easter. Pura vida. 

The author of this blog, Ticonuevo, is a US expat who moved to Costa Rica and used the services of GoDutch Realty to purchase a property in Costa Rica. In his blogs, Ticonuevo describes his own experiences of taking the step of moving to Costa Rica and getting a new life started.

 

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Ivo Henfling

If you are looking to buy a home in Costa Rica or invest in a condo anywhere in the central Valley, or looking for any property for sale in Escazu, you need to call me. I have been selling real estate in Escazu for over 20 years and can show you hundreds of happy buyers of real estate in Escazu and other areas. To me, a deal is not a good deal unless both buyer and seller are happy.

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