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Jun 03 2017

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Jackson’s Care – A Cost Effective Option for Private Healthcare in Costa Rica

In addition to MediSmart, Hospital Metropolitano’s discount healthcare plan, there is now another option. Jackson’s Care is a brand new plan offered by Jackson Memorial Medical Center. We have been meeting with them over the last two months to understand and document the plan in English for our readers.

Jackson’s Care provides a cost effective alternative to healthcare for you and your family in Costa Rica. It is a preventative health plan, a “wellness plan,” and is designed to give you the best prices for doctor’s visits, blood work, and other diagnostic tests. In the plan, you are encouraged to get a full medical baseline by meeting with a primary care physician on a regular basis, seeing specialists when needed, and having all appropriate diagnostic tests.

What services does the Jackson’s Care plan include?

Services provided:

  • General practitioners
  • Medical specialists in:
    • Nutrition
    • Cardiology
    • Dermatology
    • Surgery
    • Gynecology
    • Ophthalmology
    • Pediatrics
    • Urology
    • Orthopedics
    • Otorhinolaryngology
    • Internal Medicine
    • Family Medicine
    • Geriatrics (applicable only with the Gold Plan
  • Laboratory (blood work)
  • X-Rays & Ultrasounds

How does the Jackson’s Care plan work?

When you join the Jackson’s Care Plan, you can start using the services as of the date indicated on your membership card. Just call the Redbridge Call Center at (+506) 2520-0210, 24 hours a day/7 days a week, or email them at costarica@redbridge.cc. They will schedule your appointments with their affiliates and manage your health care needs and treatment.

Their service promotes health education, awareness, and understanding, as well as better utilization of health services. They require that your first appointment is with a general practitioner; then they will make other medical appointments for you as necessary.

What is covered under the various Jackson’s Care plans and for which plan do I qualify?

Note: For each of the following plans, the benefit totals listed in each category are per person and per year.

STANDARD AMBULATORY MEDICAL CARE PLAN

(For people between the ages of 1 and 58 years, 364 days)

PLATINUM OUTPATIENT HEALTH CARE PLAN

(For people between the ages of 1 and 58 years, 364 days)

GOLD OUTPATIENT MEDICAL CARE PLAN

(For people between the ages of 59 and 84 years, 364 days)

What are some examples of “High Complexity Exams?”

  • Colonoscopy
  • Gastroscopy
  • Bone density scan
  • Pelvic endovaginal ultrasound
  • Prostate and Urinary tract ultrasound

What are some examples of “Special Exams?”

  • Electrocardiogram
  • Hepatitis antibody test
  • Testosterone levels (free and total)
  • Vitamin B-12 levels
  • Cortisol levels (blood or urine)

Where can I use my Jackson’s Care plan?

You can use your plan at hospitals, medical center, and labs all over Costa Rica. Here are a few examples:

San Jose area

  • Hospital Metropolitano
  • ServiSalud
  • Hospital Cristiano Jerusalén
  • Hospital La Católica
  • Clínica UNIBE
  • Hospital Metropolitano Tibás

Pérez Zeledón

  • Clínica El Labrador
  • Clínica de Urgencias PZ
  • Plaza Medica

Escazú

  • Blue Medical

Alajuela

  • Clínica San Miguel
  • Clínica Peña

Naranjo

  • Clínica de Especialidades Medicas San Gerardo

San Ramón

  • Centro Medico Jackson Memorial

San Carlos

  • Hospital Cooperativo ConSalud

Heredia

  • Centro Clínico Orozco
  • Centro Medico San Joaquín

Liberia

  • Hospital Centro Medico San Rafael Arcángel
  • Clínica Integral Santa Cruz
  • Hospital Metropolitano Cabo Velas

Limón

  • Clínica Medica Walters y Chavarría

Cartago

  • Clínica Universal de Cartago
  • Clínica Señora de los Ángeles

Turrialba

  • Centro Medico Laxmi

To receive a full list of affiliated providers and the services available at each, just call the Redbridge Call Center at (+506) 2520-0210, 24 hours a day/7 days a week, or email them at costarica@redbridge.cc.

What will my out-of-pocket cost be to use the plan?

Since most readers of Retire for Less in Costa Rica are at or near retirement age, we will use the “Gold Outpatient Medical Care Plan” for the cost breakdown.

The monthly cost of the Gold Plan is 7,827 colones per month (about $13.65 per month at the current exchange rate of 574 colones to the dollar). Therefore, enrollment in the plan per person for the mandatory 12 months would be 93,924 colones (about $169).

In general, the base rate for an appointment with a general practitioner is around $50, and the base rate for a specialist is around $90. Your out-of-pocket fee will be that amount minus the percentage of discount provided in your plan. So, if you are 59 years of age or older, you would pay the following:

  • General Practitioner: $50 minus 60% discount, or $20
  • Specialist: $90, minus 60% discount, or $36

Each individual provider of medical services sets their own fees, so your actual base fee may vary. You will pay each medical provider directly at the discounted rate.

Jackson Memorial Medical Center

One important thing to note is that each time you have a medical issue, you will first need to see your primary care doctor before making an appointment with a specialist. This allows the primary care doctor to better manage your care and eliminate the extra cost of seeing a specialist unnecessarily.  Should you want to see a specialist without seeing a primary care doctor first, you have the option to do that outside of the plan. Jackson Memorial Medical Center allows plan members to see the specialists at their clinic in San Ramon de Alajuela at a discounted rate of 10% off the regular prices and 20% off laboratory testing. (Other local clinics may also offer off out-of-plan discounts but you would need to check with each clinic individually.)

After all of your plan benefits have been used for the year, Jackson Memorial Medical Center allows plan members to obtain services at their clinic in San Ramon de Alajuela at a discounted rate of 10% off the regular prices, with 20% off laboratory testing.

How can I pay for the Plan?

Monthly Payment through Debit of your Costa Rica Bank Account (Any Bank in Costa Rica)

Since you need to be a legal resident to have a bank account in Costa Rica, this option would only apply to legal residents.

  • Set up authorization for automatic debits to bank accounts, on the customer’s choice of day
  • Payment of monthly fee through direct debit
  • Waiting time for use: 7 days
  • First deduction according to the date of acquisition

Annual Payment at Coopenae Cooperativa

Since no Costa Rica bank account is required, anyone can use this option. You do not need to be a legal resident or have an account at Coopenae. You can pay for the plan at any Coopenae branch after first completing all required paperwork to enroll in the Jackson’s Care Plan.

  • By pre-payment to Coopenae of the entire contract amount
  • Annualized payment for 12 months of the plan
  • Waiting time for use: 7 days

Note: Coopenae is a Costa Rica cooperativa (credit union) and a partner in offering the Jackson’s Care plan.

Payroll Deduction through Coopenae 

Since the great majority of our readers are not salaried employees in Costa Rica, this option would not apply to most. However, in case someone reading this is employed in Costa Rica, we opted to include the following information:

  • Payment of monthly fee through payroll deduction
  • Waiting time for use: 7 days
  • Coopenae uses the payroll deduction system through agreements already established with institutions, which determine the how often the deductions are made (weekly, biweekly, monthly, etc.)

The effective date of your plan begins after the 7 day waiting period.

Does Jackson’s Care Plan make sense for me if I am a “snowbird?”

You will have to make this determination for yourself. While you can suspend your year’s contract in the plan with 30 days notice, there is a penalty of approximately $40. So, as an example, for someone over age 59 who is only in Costa Rica for five months of the year, the actual plan costs would be as follows:

Five month’s plan membership: 7,827 colones x 5 = 39,135 (about $68.18)

Contract suspension penalty: $40

Actual monthly cost of the plan for this person: $118.18 divided by 5, or $21.64 per month

In the end, whether or not the Jackson’s Care plan is right for you is your decision. It may be a particularly good option for people living outside of the Central Valley, in Perez Zeledon, Liberia, or San Carlos, for instance. Our goal in providing you with this information is to give you options for medical care in Costa Rica, whether you live here full time or for part of the year.

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