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Moving Back to US Due To Health Care Expenses

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From what I have been reading on other sites, some are moving back because they are finding health care to now be cheaper in the U.S. what with the Affordable Care Act. How long that will last is anybody's guess.

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The only expats I know who moved back didn't want to and did so for medical reasons. Though the quality of care in many areas here is equal to the US, they felt there would be more drug trials and experimental studies they could have access to in the US (for Parkinsons). Having Medicare may also be a factor. And Affordable Care Act - I don't know much about that.

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News reports I've read in the last few days have noted that a growing number of doctors and clinics are refusing to accept ACA (aka ObamaCare) patients, limited treatment locations.

 

Of course here we are limited to CAJA facilities (if using CAJA), so there are strong parallels between ACA and CAJA.

 

On the other hand, pay-as-you-go here is much more available and cheaper than in the States, so I doubt medical will remain a reason to go back.

Edited by CMinCR

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Fee-for-service is definitely less expensive here than in the U.S., but with the advent of Obamacare, many more people in the States have or have access to insurance coverage to pay those higher costs. Some expats who originally came to Costa Rica to take advantage of its accessible medical care may be finding that care in the U.S. is equally accessible now.

 

And, at the same time, the range of services, especially at the highest levels of sophistication, is much greater in the north. A population of 4.25 million or so just cannot support the medical infrastructure that a population of 320 million or so can.

 

You can rest assured that as insurance coverage becomes more widespread, providers will accept it or leave the field. Many insurance companies which declined to participate in the exchanges originally are now indicating their intention to participate, and the early evidence is that costs will be less than originally projected.

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Once my hubby quits work this year and we move to CR, we won't have any health insurance. So, I just went to the healthcare.org site to see how much the cheapest plan will cost us. I learned 2 things. First, dental coverage is provided with some of the plans. Second, for the two of us the cheapest plan will cost $802/month. That is based on the state and county where we currently live.

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Once my hubby quits work this year and we move to CR, we won't have any health insurance. So, I just went to the healthcare.org site to see how much the cheapest plan will cost us. I learned 2 things. First, dental coverage is provided with some of the plans. Second, for the two of us the cheapest plan will cost $802/month. That is based on the state and county where we currently live.

 

That is not what I would call affordable, at least not for me, yet with my BC of FLA and Medicare A & B premiums I'm paying around $380.00 per month just for myself. At least with Medicare I stopped having to pay all but a couple co-payments, which was a significant saving.

 

I'm still miffed at having to pay for CAJA every month when it is unlikely I'll ever use it. It's more practical for me in CR to walk in off the street and pay out of pocket for care at private clinics, at least so far it has been. I actually prefer a walk-in/ out-of-pocket arrangement to CAJA. I wouldn't complain about CAJA for emergency trauma, heart attack, etc. though, and would expect to pay for it if I had to use it for that.

 

OK - EOW*

 

Cheers!

 

Paul M.

==

 

* End Of Whine

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From what I have seen the OBAMACARE programs for the lowest priced premiums include a very large deductible of 5k or more a year. This is reduced as you go from bronze plans up to gold or whatever they are calling them. But the premium for a higher deductible (IE the cheapest plan) plan is very high. Much more than my private plan through ins (1,500 per year with a new this year $300.00 deductible in addition)

 

Add on top my caja payment of $50.00 per month (I got in a long time ago so pay less) which half of the premium is for a pension which will be around $ 220.00 a month when I retire at 65 and then they also wiave the caja medical fee at the point you are pensioned with them.

 

I would ask if I were applying for CAJA now that they not charge the half of the cost for a pension if you are 55 or older as you will not be able to qualify for a pension as you wont have time to make enough monthly payments to qualify. I think they will charge you the pension part but you may not be able to live long enough to qualify for it.

 

Ask them for a letter that explains how you qualify for a pension at what age if you start paying now at 55 or older. You should be able to get out of 50% of the payment as there is no way to be able to get the pension part depending on your current age.

 

Not sure if this would work but I would demand that they give you something in writing that says if you pay the pension part that at x age you qualify for some type of pension and the waiving then the medical fee portion.

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I would ask if I were applying for CAJA now that they not charge the half of the cost for a pension if you are 55 or older as you will not be able to qualify for a pension as you wont have time to make enough monthly payments to qualify. I think they will charge you the pension part but you may not be able to live long enough to qualify for it.

Those who are 55 or older when affiliating do not pay into the CAJA pension system. You don't have to ask, it is automatic.

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Hey Mark, well that would be good news if they only charge the medical portion to those 55 or older. I am not familiar with the current process as I got into the system a longtime ago.

 

All I can say is that looking at my monthly receipt the percent charge for both items of my listed salary or ingresos es %12.28 percent total which is close to the 13% I hear from the forums that is the current charge for residents.

 

However the bill is broken into two specific items each of which is exactly half of the total cost per month.

 

One is called Sem Obrero with a code of 0001 which I think is the medical portion. The other is listed as code 0035 called I.V.M. obrero which I think is the pension part. Both are the exact same fee and add up to the 12.28% listed.

 

So I am thinking if this is the case for me and If I did not have the pension portion included should I not then pay only the medical portion which would be 6.14%?

 

Again I have no details of the current process but by process of logic then they are charging the same percentage as if a person had the pension even though they wont receive it because they will not have enough time to qualify.

 

Maybe someone from ARCR can define this and at the least if I were new and getting processed for the CAJA I would be sure that the person issuing the fee at the CAJA does not try to slip in a charge for pension for someone over 55. They may try to include that on everyone.

 

Or maybe the new rule is 13% on income just for medical and in that case this does not apply.

 

best of luck to all on this now very thorny twist to residency.

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rodo - Our CAJA premium is also split into two parts, each half equal to the other. I've never really paid attention to it since my esposo pays the bill online with the rest of our bills, but I've always assumed it is medical/pension since we were both 38 when we joined CAJA.

 

Jessica

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I wonder how this would reflect if the principal applicant is over 55 with a spouse who is under 55?

 

Mornin' CRL,

 

From what has been posted here in the past it's the status/age of the principal applicant that determines whether the pension portion is paid. So the spouse and any dependent children fall under the umbrella of the primary applicant's CAJA affiliation.

 

HTH

 

Paul M.

==

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