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May 31 2015

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Retire for Less Newsletter – June 1, 2015

Welcome to our Retire For Less In CostaRica Newsletter

Paul and Gloria

In This Issue:

 

 

Retire for Less Goes to Mexico!

It’s time again for our annual trip to Mexico. We will be traveling the entire month  of June to Cancun, Mexico City, and Oaxaca.

Market Day at Ocotlán Oaxaca Mexico

Market Day at Ocotlán, Oaxaca, Mexico

Gloria will be going to cooking school again and Paul will get to eat all of his favorite Mexican dishes. We are grateful that International Living asked us to speak at their Ultimate Conference once again and are paying our airfare, which helps make our month in Mexico possible. We’ll definitely be traveling the “retire for less way” after the conference!

Thank you in advance to our wonderful house and pet sitters (and regular readers of our newsletters), Bill and Barbara, who will take care of things here while they get to know San Ramón and surrounding areas of Costa Rica.

We will continue to send newsletters while we are traveling, as much as possible, so stay tuned!

Related Articles:

 

Our Costa Rica Healthcare Plan

by Rob and Jeni Evans

Rob and Jeni Evans

Rob and Jeni Evans

Admit it. In spite of the beautiful beaches and the tropical weather, affordable health care is a huge factor in why people retire to Costa Rica. Although I qualified for a pension at age 55, I found I had to continue working just to pay for my health insurance. While I was still working, the Cadillac plan for a couple, age 55+, cost $13K per year, of which I had to pay $6K (with my company paying the other $7K). Furthermore, the insurance company would only reimburse 80% of expenses (up to $5M) AFTER I met a $5K deductible. My retirement severance package included my company paying the entire premium ($13K/yr) for three years, after which I could continue paying the $13K myself. With the deductible, I would pay a total of $18K ($13K premium + $5K deductible) before receiving any benefit.

There was no way after retiring I could afford that price, so I needed to formulate a plan. Below is the three-step health plan I developed to retire in CR.  Note: I do not claim this plan is the best plan, nor even that it will succeed; but it is my initial plan that I will go with until it needs revision.

  1. Improve health by reducing stress and by improving sleep, exercise and eating habits. 
  2. Join the CAJA (public) and INS (private) and make use of them. 
  3. Seek out specialists for preventative testing and advice.

healthplan-appleThe corollary of the first step is “don’t get sick.” In addition to losing a few pounds and exercising to stay fit, I wanted to eliminate toxins and processed foods from my diet, make sure I was getting enough hours of REM sleep, and monitor my health through more regular check-ups. While these healthy habits seem obvious to me now, I was all too entrenched in the US car-centric lifestyle where being busy and stressed out is celebrated, pills are the answer to every ailment, and processed foods support the on-the-go family with excessive toxins, fat, salt, and calories. It takes planning, commitment, and will power to implement a healthy lifestyle. Although it is possible in Costa Rica to continue bad habits formed in the US, moving to another country provided a unique opportunity for a complete change in the way I live.

Caja_Seguro_Social_Costa_RicaOnce we established our residency, we were able to continue with step two and join CAJA, the public healthcare system available to residents and citizens. The CAJA has no restrictions on pre-existing diseases and no age limit.  The monthly CAJA premium people quote is wide ranging, but it is supposed to be 9-13% of your declared income.  So, 10% of the $1000 required for pensionado status is $100/month with no deductible, no age limit and no maximum. Clearly, this is a huge savings compared to my company’s plan. But I have heard that many expats don’t bother to use the CAJA—perhaps because they are unfamiliar with how it works, they have heard bad reviews, or they struggle with Spanish. Since this is essentially a 10% tax on my income, I want to learn how and when to use it.

injured-piggyWe will use CAJA for regular checkups / minor ailments and the public hospital for emergencies until we understand CAJA and gain faith in it. Until I learn enough Spanish and get over my US instant-gratification attitude, using CAJA will probably present a bit of a challenge at first. However, retirement provides me with the time to learn, so I can adapt to the process.

Although I might not need it, I am uncomfortable not having private insurance at this point, so I signed up for INS, the government health insurance monopoly which only works with private hospitals. INS excludes pre-existing diseases and ends at age 70.  So, I can only use CAJA at public hospitals and INS at private hospitals. Private hospitals include top rated Clínica Bíblica and CIMA, both of which handle a lot of medical tourism.  INS requires a physical in San Jose which they schedule for free. INS INS_logocosts $3K per year (for a 55 year-old couple through ARCR) with a $300 deductible, and INS pays 90% after the deductible is met with a $200K limit. I know some people freak out over a $200K limit vs. the US $5M limit, but I understand that $200K goes a long way in Costa Rica. There are other benefits with INS, such as yearly eye exams, physicals, $10K travel insurance, death benefits, etc., that I still need to investigate.

My third step, to make better use of preventive care, means more than simply getting in better shape. Typically, because of the cost in the US, many of us fail to have regular diagnostic tests such as mammograms, colonoscopies, or dermatological exams and only seek medical attention when symptoms occur.

DocSignRXAlso, since doctors are under tight time constraints, we rarely have a good long talk with them about our health and habits. Another concern is the questionable relationship doctors in the US have with pharmaceutical companies and their free samples and the push to try this or that chemical solution instead of leading with good general health practices.

I have heard from friends here that Costa Rica’s doctors spend more time talking with their patients and rely less on pills and antibiotics. Indeed, when you go to the pharmacy, the pharmacist will ask how many pills you need, rather than hand you a bottle of 500 pills. Because medical tests and specialists cost less here, I can consult with the appropriate professionals to understand, prevent, and avoid many ailments before they become problematic.

farmaciaIn Costa Rica, my first point of contact for medical needs often will be the pharmacy.  Pharmacies in Costa Rica provide most drugs without prescription and have a doctor on staff to treat minor ailments like stomach aches, burns, rashes, headaches, diarrhea, etc.  If my need is greater, I will go to the CAJA doctor (public), ER (public) or private doctor/ hospital depending on what I need and how fast I need it.  The overall plan is not as simple and straightforward as I wanted, but I am convinced it is better quality care for less money than I would have had in the US after my employer’s plan ran out.

So in summary:

  • Care Flow: pharmacy, public doctor, public hospital, and private hospital.
  • Summary2Preventive: I will change my lifestyle to prevent getting sick.  I will initially go to the local clinic (EBAIS) for regular checkups and to discuss my health concerns.  I will pay out-of-pocket for specialized preventive checkups from dermatologists, ophthalmologists, gastroenterologists, and cardiologists.  Note: these are available from through the CAJA (takes time and referral), but I want to speed up the process and get on top of my health care now.
  • Reactive: I will go to the pharmacy initially for minor cuts and burns, allergies, headaches, diarrhea, stomach aches and other minor ailments.  If the problem exceeds the pharmacy’s ability (stitches, broken bones, internal bleeding, stroke, etc.), I will go to the ER at the local public hospital (CAJA). If I am not happy with their care, ability or speed, I will transfer to a private hospital (INS).

As I learn more Spanish and better understand the healthcare system, I hope to eventually drop INS and rely entirely on the CAJA.  So, I will move from $18K (US Cadillac plan) to $4K (CAJA + INS) to $1.2K (CAJA only). There are more complications ahead when I turn 65 and have to make Medicare decisions, and when I turn 70 and lose INS, but that is still several years away.

Related Articles:

 

Were Costa Ricans Always Pura Vida? — Where History Meets the Movies

A reprint of one of our favorite articles, originally published July 12, 2014.

10431230-pura-vida-costa-ricaLiterally, the expression “pura vida” means “pure life.” It describes a peaceful, tranquil and free-from-impurities existence. For the Costa Ricans, the phrase “pura vida” means much more:  It has become the popular but unofficial national motto. This motto is associated with all Costa Ricans world-wide.

Where did the phrase “pura vida” come from?

Costa Ricans started using the expression “pura vida” after the premier of a Mexican movie called “Pura Vida” in 1956. This expression gained popularity in the ‘70s because the words conveyed the states of happiness, peace, and tranquility which were, and still are, symbols of the liberty brought on by the country’s political stability. Remember, Costa Rica abolished its army and navy in 1948, and the thought of war is just not a part of their mentality. So, if you were to hear the utterance “pura vida” anywhere in the world, you can bet it would be coming from a Costa Rican. It’s a dead give-away.

The popular expression is used by Costa Rica and by Costa Ricans around the world to remember their beloved native country. The expression is used informally, with various meanings, depending on how it is used. It could be a greeting, a way of saying goodbye, or a show of appreciation for a person, object, or situation. Sometimes it’s like saying “Everything’s all right,” or “No need to worry” or “It’s a beautiful day and life is good.”

Does “pura vida” mean “perfect?”

The lives of Costa Ricans are far from perfect. But, “pura vida,” if said often enough, becomes an affirmation which focuses the speaker on the positive. It’s just positive self-talk, all day long. I know it works because I say it often too. It’s an easy and great way to stay positive.

Caja_Seguro_Social_Costa_RicaOne reason they are “pura vida” are the social reforms that were passed in the early 1940s. The Caja, Costa Rica’s national healthcare system, began in 1940 and was available for both urban and rural workers. It brought health care to the people and insured that everyone had the beginnings of access to basic medical care. In addition, a labor code was passed which established a minimum wage for all workers, an 8-hour workday, a six-day work week, and the right to organize which protected them against arbitrary dismissals. It also made collective bargaining mandatory in labor/management disputes.

But, as I mentioned, a Tico’s life is far from perfect. They have problems too (similar to the U.S.):

  • 40% out-of-wedlock birth ratedivorce
  • 50% divorce rate
  • High incidence of domestic violence
  • 48% high-school drop-out rate
  • 5% inflation
  • Low paying jobs and high unemployment
  • $750/month average salary
  • General feeling of helplessness regarding government and politicians which they regard as self-serving and corrupt

They have personal problems, like all of us, but you would never know it. They are just too “pura vida” to allow the negatives to overwhelm them. It’s a peace-loving nation with honest elections and comparatively high quality of life. It even scored the highest of 151 countries in the latest Happy Planet Index. “The country has embraced sustainability in its national policies: it produces 99 per cent of its energy from renewable sources, has reversed deforestation in the country, and, in 2008, committed itself to becoming carbon neutral by 2021. Costa Rica has the second highest life expectancy in the Americas, higher than the USA’s; experienced well-being higher than many richer nations; and a per capita Ecological Footprint one third the size of the USA’s.” (HPI Report, p. 13)TheTicos

Were Costa Ricans always “pura vida?”

So, why “pura vida”? Where does it come from? And why did they adopt this slogan now recognized world-wide? “Pura vida” is based on how the country developed over centuries. Costa Rica’s been “pura vida” for over 500 years…it just wasn’t called that.

In the book, The Ticos: Culture and Social Change in Costa Rica, the authors describe the early Spanish colony in Costa Rica and how it differed from other Spanish colonies in Guatemala, Nicaragua, and Colombia:

“The colony was tranquil in part because it was poor. Mineral wealth – a bone of contention in other colonies – remained undiscovered. Although land was readily available by the eighteenth century most colonists had only family labor to work it. The tiny settlements were isolated from one another by heavy rains, broken terrain, and a lack of roads. Finally, Costa Rica was remote from other colonies, which were often the scene of raging disputes.mapa-america-1680In 1809 Governor Tomás de Acosta, like his predecessors since 1648, reported that everyone still lived near a subsistence level. Compared to most other Spanish colonies, Costa Rica was indeed poor. But historian Carlos Monge Alfaro saw in the humble colonial farmer, with his love of liberty and autonomy, the foundation of Costa Rica democracy. Each farm, he wrote in a text used in schools through many editions, was,

…a small world in which family was born and raised far from other farms. The simple life, without ambitions or desires, gave the inhabitants a rude, distrustful, very individualistic character. They were without exception peasants who had to till the soil for their food; as a result Costa Rica became a rural democracy. Unlike other Spanish colonies, Costa Rica had no social classes or castes, no despotic functionaries who looked down on others, no powerful creoles owning land and slaves and hating the Spaniards, no oppressed mestizo class resentful of the maltreatment and scorn of the creoles.  [Carlos Monge Alfaro, Historia de Costa Rica, 14th ed. (San José) Trejos, 1976, p. 192.]”
Mavis Hiltunen Biesanz, Richard Biesanz, and Karen Zubris Biesanz, The Ticos: Culture and Social Change in Costa Rica, (Boulder, Colorado) Lynne Rienner Publishers, Inc., 1999, pp. 18-19.

This is the reason they are pura vida. They grew up isolated. It was a small population of people with little outside contact. They didn’t bother anybody and nobody bothered them. They developed independently. That’s why they are so different from Nicaragua and Panama today. Even the few rich coffee plantation owners, who lived in the San Jose area, had very little to do with the peasants who lived in the country. It was a tough life for the campesinos but, in many ways, an idyllic life.

PuraVidaBeachTicos and Pura Vida

Life in Costa Rica has never been perfect, but Ticos felt that the phrase, “pura vida” just fit them. They took it on to describe a life and a place where they are free to do their own thing, breathe fresh air, drink clean water, eat fresh fruits and vegetables year-round, and share their lives with family and close friends. It’s a place where they don’t have to worry about going to war or losing everything they own to pay for health care. It’s a place where they have a voice in the democratic system of government. It’s a life that can be summed up in just two words…”pura vida.”

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Our Ultimate Healthcare Tour of Costa Rica

Our newest tour is the Ultimate Healthcare Tour of Costa Rica. When asked what he liked best about our healthcare tour, one of our guests wrote, “the wide variety of places we saw, the experts that Paul HCTOUR_030arranged for us to meet and talk with, and an emphasis on all aspects of health, not just doctors and hospitals. Mental health is just as important as physical, if not more so.” HCTOUR_008

We’ve lived in Costa Rica for over five years and have used the Caja, Costa Rica’s public healthcare system extensively, as well as the private system, when needed. We’ve learned the system and have been referred up the ladder to see specialists in the maze that is the Caja system. Gloria’s even had surgery here.

Our blend of personal insights and on-the-ground experience combines to answer your questions about whether or not Costa Rica’s healthcare system could meet your individual needs.

HCTOUR_004

 

But, while it is focused on healthcare, you will learn a lot more about living and retiring in Costa Rica’s Central Valley. Most of the second day of the tour takes place in the town of San Ramón where we live and use the services. And you will come to our home for lunch that day to listen to two of our featured speakers. Our tour is designed to save you both time and money, packing a lot of information into a short period of time. Our goal is to show you the possibilities and to try to demystify Costa Rica’s healthcare system. Our tour lasts two days and 1 night and includes lodging, transportation, meals and non-alcoholic beverages.

Sample Itinerary

You’ll visit:

  • At least two private hospitals in San Jose area
  • Hospital Mexico, the largest and best public hospital (they even do open heart surgeries there)HospitalMexico
  • An insurance broker for a presentation on the various supplemental health insurance options, including public, private, and international plans
  • A senior living retirement community
  • CPI language school for a presentation about how learning Spanish increases your options for healthcare and some basic medical Spanish.
  • Our local hospital here in San Ramón
  • A local EBAIS (community clinic)
  • A local private medical and dental clinic
  • A local Seguro Social office where you would sign up for the Caja (national healthcare coverage)
  • A pharmacy
  • A health food store (macrobiotica), and more!

EBAISStaffYou’ll learn:

  • If the Costa Rican healthcare system could meet your needsand put your mind to rest, once and for all, about this sensitive subject.
  • About the public system and how it works, about the private healthcare system, and how you can use a combination of both to your advantage.
  • About the EBAIS – where healthcare starts in Costa Rica.
  • Approximately how much you would pay for Caja.
  • About medical tourism in Costa Rica.
  • About home health care in Costa Rica.

Introductory prices: $550 for a couple, $450 for a single.

Please contact us if you are interested in booking this tour. Space is limited.

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Featured Property:San Ramon: House in Gated Community with Pool and Tennis-$130,000

ID259-1777.jpegProperty ID: 259

Sell: $130,000 USD

Location: San Pedro de San Ramón, Alajuela, Costa Rica

Area: 500 m2

Construction: 160 m2

Bedrooms: 2
Bathrooms: 2
Year Built: 2010

 

ID259-1781.jpegAdditional features:
Gated Community
Covered Parking
Home Owners Association

Description

Vistas del Valle in San Pedro de San Ramón. All the conveniences of being in town but surrounded by beautiful views and open spaces.

Secured, gated community with pool, clubhouse, tennis and 24hour guard.

ID259-1779.jpeg5 year old, 2 bedroom, 1.5 bath home with electric gate, concrete perimeter wall and a separate rancho area with its own bathroom. Plenty of room for a private pool.

The house consists of a very large master suite with large walk-in closet and jacuzzi tub, one small bedroom (with room to expand) , a half bathroom for guests, living room, dining room and large kitchen with plenty of cabinets.

ID259-1784.jpegLaundry room with interior space to hang clothes. Hot water throughout home.

Association fee of only $76.00 per month.

 

 

 

 

 

ID259-1783.jpeg

Click here for more photos and information and to contact the realtor for this property.

Click here to check out our other properties under $150,000 and read about what to do before you buy.

 

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Permanent link to this article: http://retireforlessincostarica.com/retire-for-less-newsletter-june-1-2015/

2 comments

  1. mches56

    I was wondering if Rob and Jeni Evans had any follow-up comments concerning their health care ins. decisions?

    1. Paul & Gloria

      Hi. Good question. I will ask them.
      Gloria

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