Apr 05 2018

Retire for Less in Costa Rica – April 6, 2018

Welcome to our Retire For Less In Costa Rica Newsletter

Paul and Gloria

In This Issue: 



Our Recent MediSmart Experience

We continue to be pleased with both the service and prices we receive through Hospital Metropolitano’s MediSmart Plan. For the two of us, the plan costs $180/year and gives us discounted rates on doctors visits, laboratory and radiology, prescriptions, hospital stays and even operating room costs.

Dermatology Consultation Office

In February and March, Paul and I scheduled some routine visits with specialists. We both saw a dermatologist at 60% off the regular price. She spent an hour with each of us and checked everything from our scalps to between our toes and everything in between. Cost for each 1-hour appointment was 18,000 colones (less than $32). She also biopsied a tiny growth on Paul’s nose that she had been keeping tabs on. The cost for the biopsy was 20,000 colones (about $35) and we were promised the results in about 10 days by email. We actually received an email from the doctor six days later with positive results. Total cost was $36,000 colones ($63.53).

I also had an appointment with a gynecologist through MediSmart. Why didn’t I see a gynecologist through the Caja? We were told early on that unless a woman has a diagnosis of a serious gynecological condition such as cancer, the wait for a non-urgent appointment could be years. Therefore, I have always had my routine checks done privately. The discount for this type of specialist was 80% off the regular cost, so I paid only 9,000 colones (less than $16) for the visit. In addition to the consultation, she also performed a PAP test and IU Ultrasound. The total price came to 30,000 colones (about $53 USD). I received the ultrasound results immediately and was told that it would take about two weeks to receive the results of the PAP by email. One negative is that I never received the results of the PAP. I emailed the doctor and did not receive a reply. I have a follow-up appointment in a few days, so hopefully she will have the results at that time.


My gynecologist also wanted me to get my hormone levels checked, and to have both a mammogram, breast ultrasound, and bone density test. We scheduled those tests over the next couple of weeks. The mammogram and breast ultrasound cost us a total of 30,000 colones and the lab work cost 106,349 colones, for a total of $240.63 USD. In the past, I have always had my mammograms done through the Caja, but since I was having all of these other tests done through MediSmart, I decided to have the mammogram done privately as well. I received the written results of the mammogram and ultrasound, along with the films, about 10 minutes after the tests were completed. By the time we got home that afternoon, I had received the results of most of my lab work by email. A few of the tests would take a couple of days longer. Another negative is that I had to follow-up on the remainder of my laboratory results. After more than a week, I had not received them so I sent a follow-up email. Still no response. Luckily, Paul was visiting the MediSmart office with one of our healthcare tours and he stopped in the lab and explained the situation. Within 30 minutes, I had received the remainder of my results.

We had to go to another location within the MediSmart system for the bone density scan. (Note: in Spanish, this test is called “densitoetría ósea cadera y columna.”) We were every bit as pleased with the treatment we received at the Lindora Medical Center. I was promptly seen at my appointment time, the technician was courteous and professional, and I received the scans and a written report of the results about 10 minutes afterwards. Total cost for this test was 24,921 colones ($44 USD).

The same day of my gynecologist appointment, I also had an X-Ray of my hip. I had been having some vague hip pain for some months and had an X-Ray taken through the Caja at no cost. However, when I asked how long it would take to receive the results, I was told that it would be at least four months. The Caja can take a long time for non-urgent care and Paul and I decided we didn’t want to wait that long. So, I had my Caja doctor write another order and had the X-Ray done at Hospital Metropolitano. With our 40% discount on X-Rays, the cost to us was 22,784 colones (about $40 USD). I was given the films about 5 minutes afterwards and received the results by email about 2 hours later. This is a good example of how we, and many others, use a blend of public and private healthcare. Getting the results in a timely manner put my mind at ease and was, therefore, well worth the $40 it cost to have the test done privately.

We have found MediSmart to be a cost-effective way of handling our healthcare needs and have been very impressed with both the doctors we have seen and the quality of the other services. The only negatives we have experienced seem to be more administrative in nature. One specific negative is that when you make an appointment by phone, it is difficult to find someone to help you who speaks English. Even though we speak some Spanish, it can still be a challenge. We frequently have to say, “mas despacio, por favor” (more slowly, please).

Hospital Metropolitano’s MediSmart plan has an English language website which you can access at this link Though you can check their complete break down coverage in various treatment areas at this site, here are a few screenshots. (Note: the prices below are in colones. Current rate of exchange is 567 colones to $1 USD.)

Related Articles:


In the Mailbag – Tours, Body Donation, Persons with Disabilities, and Cost of Living

emaildelivery-200pxWe always get lots of responses and questions from readers, both newsletter subscribers and on Facebook.

“Hi Gloria and Paul,

Just wanted to let you know how much I appreciated having one of your personalized tours around San Ramon and area.

It was so interesting to meet all of those expat contacts of yours, many of whom have lived there for a number of years and others who were just settling in. It was inspiring to see the many and varied ways in which they are organizing their lives and finding ways to be productively involved in their communities.

Since I was mainly interested I rental options (as opposed to buying), I’m glad I got an idea of some of what is available out there.

The “walk about” in San Ramon was kind of fun because I got to watch Paul “in action” so to speak. It was cool to see how he has connected with so many people in the community and was bumping into someone he knew about every half block or so!

Even though health stuff was not my main area of interest I did find I learned a lot of useful information from you two about that and about banking in Costa Rica as well.

It was also good to find out about cultural events and even to attend an Oboe Concert while in San Ramon.

A tour like yours was very helpful even in cases like mine where I speak Spanish fluently and have had experience living  in Latin America, because you are showing so  many of the specifics of living in Costa Rica.

Thanks for a fun,  informative time!”

Patricia H.

Thanks Patricia! We enjoyed spending time with you and showing you “our” Costa Rica.

“Hi Paul and Gloria,

We had our appointment yesterday at UCIMED after your most informative article sparked us to make the move toward anatomical gifting. The process was very efficient and quick. In a recent edition of your newsletter, PJ had a question about making an appointment to do this. Sr. Carvajal is fluent enough in English to make the appointment with you and conduct the meeting, but he felt more comfortable using an interpreter at our appointment because of the legal issues involved. He wanted to make sure we completely understood the process from beginning to end. I initially emailed him using Google translate but got no response, so I opted to brave it by phone. I succeeded reaching him with my basic Spanish and then spoke with him directly in English. They are very happy to receive these requests and we left with our donation cards in hand and feeling another item is crossed off the list of necessities for end of life arrangements. Thanks so much for all the information you give us transplants!”

Arlene Grabowski

Thanks for writing, Arlene. For those interested in learning about UCIMED’s body donation plan, check out our article, “End of Life Issues – Body Donation in Costa Rica, by Judy Kerr.” 

“I would love to know the good and bad of being a disabled person with Cedula residents pension. Any and all information!!”

Lisa F.

Hi Lisa,

Thanks for getting in touch. I think it would depend on the disability. We had a tour guest who had had polio as a child and had a hard time getting around on broken sidewalks and hilly areas. He decided against CR pretty quickly. Another issue to consider is whether or not any required medications or therapies are available here. On the positive side, the Caja does not deny coverage for any pre-existing conditions.

You may want to consider taking our healthcare tour if your have specific issues you would like addressed. All of the info is on our site at this link: http://retireforlessincostarica.com/our-ultimate-healthcare-tour-of-costa-rica/

Hope this helps.


“I don’t understand how you can spout how costa rica is inexpensive.

Unless your living like a peasant, food is high, goods (clothing equipment) are high. Meds are high.

Costa Rica is one of the most expensive Latin American countries!!!!”

Hope B.

Hi Hope,

Thanks for getting in touch.

We have never said that Costa Rica is inexpensive. Never once. And we have said many times that Costa Rica is probably the most expensive country in Central America. What we do say is that we are able to live a lot less expensively than we could in the States. We tend to not buy many imported products, eat lots of fruits and vegetables, and are conservative using electricity. We live in an area where we don’t need heat or air conditioning. We live a good life, and for much less than we did back in Baltimore.

Hope this helps clarify our position.



Featured Property: Charming Renovated 3BR 2BA home in Nuevo Arenal-$150,000

Property: Ref # 218

Location: Nuevo Arenal

3 Bedrooms

2 Bathrooms

2,368 square feet

Acreage: .163 acres

Price: $150,000 USD


This beautiful home is one of the best buys in Nuevo Arenal. It’s located in a friendly, convenient residential section of Nuevo Arenal, on a quiet side street yet within walking distance to the town center. All the neighbors on this block have upgraded their homes and you can see the pride of ownership in this area.

The like-new charming home has three bedrooms, two bathrooms, glassed in porch, under roof tiled parking, a formal living room, 2 dining areas, 3 sitting room areas, a large back porch and washroom and a bodega in the ample back yard. It is being sold unfurnished and awaiting your personal decorating.

It is tiled throughout and has a new roof. Everything is freshly painted and all the doors and woodwork gleaming. Many rooms have overhead fans. The whole house is spanking clean and it is heartwarming to see the care added.

Property: Ref # 218

Click here for more photos 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.


Cooking in Costa Rica: An Expat’s Guide to Buying Groceries, Cooking, and Eating in Costa Rica


I’m so excited to announce that my new book, Cooking in Costa Rica: An Expat’s Guide to Buying Groceries, Cooking, and Eating in Costa Rica is now available on Amazon.com! Here are a couple of my 5 star reviews:

“Outstanding. I have been looking for a book that would tell me where to buy certain items that are not available in the local Costa Rica stores and I found all of that and more. Information such as translation from English to Spanish and of course Spanish to English. This is helpful so when I am shopping I can find what I am looking for using the translation. There is a break down of measurements and substitutions that was helpful. I like the few recipes that are included, and can’t wait to try them. This is a great book with so much information to help you learn about cooking in Costa Rica. I love the layout of the book and the clear explanations, and its easy to locate what I am looking for without going through an entire book. Also the resources in the back have been super helpful. Thanks so much for the book.”

“Practical as well as scholarly, this is a must-have guide for any man or woman who commands a kitchen in Costa Rica. Wonderfully readable and quickly useable for whatever and whenever you may need to know all things culinary in Costa Rica. And if that were not enough, what an amazing tour guide for English-speaking lovers of food in a Spanish-speaking culture, where the recipes you know and have always loved can come alive in new and exciting ways. I just feel smarter having read it!”

When you move to a Spanish-speaking country, it can be daunting to stock your kitchen and cook meals when you don’t know what your ingredients are called in Spanish. And even when you know the Spanish translation, it can be a challenge at times to find what you are looking for.

You can download this practical, comprehenive guide and on-going reference tool on your smart phone or iPad so you have it with you whenever you shop. The table of contents is interactive, so you can easily click through to the meat section when you are at the butcher shop (carnicería) or to the dairy section when you are standing in front of the dairy case. Here’s what you will find inside:

  • A little bit about me, our life in Costa Rica, how and where we shop for groceries, what we spend, and some insights about grocery shopping in Costa Rica.
  • An English-to-Spanish and Spanish-to-English food dictionary, broken down into the following sections:
    • Fruits
    • Vegetables
    • Meat & Poultry
    • Fish & Seafood
    • Grains, Nuts, Seeds, & Baking Ingredients
    • Dairy & Eggs, Refrigerated & Frozen Foods
    • Beans, Canned & Prepared Foods
    • Herbs, Spices, & Seasonings
    • Condiments
    • Beverages
  • An English-to-Spanish and Spanish-to-English food dictionary in alphabetical order.
  • An English-to-Spanish and Spanish-to-English dictionary of things you find in the kitchen.
  • A Glossary of cooking terms and helpful adjectives to use when buying and cooking food, ordering in a restaurant, and reading recipes in Spanish.
  • Recipe substitutions for when you can’t find familiar ingredients here in Costa Rica.

Chipotle Beef Chili

  • Recipes which I have adapted to use with ingredients found in Costa Rica, plus some favorite recipes of other expat cooks in Costa Rica.
  • A U.S. Measure to Metric Conversion Guide for temperature, volume, weight, and length.
  • A resource section with links to expat cooking blogs, Facebook groups and pages, specialty products, and other food-related things.

Buy the print edition on Amazon.com

Buy the Kindle edition on Amazon.com

If you don’t have a Kindle, you can download the Kindle app for your iPad or computer at this link.


I hope you enjoy my book and find it useful!


Our Ultimate CR Healthcare Tour

We are proud to offer 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 eight 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.


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 that day to listen to two presentations.

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)
  • The office of our dentist in San Ramón
  • A local Seguro Social office where you would sign up for the Caja (national healthcare coverage)
  • A pharmacy
  • A local feria (farmer’s market) where you will see the abundance of fresh food available.
  • The local Cruz Roja (Red Cross) to learn about their services and programs.
  • A health food store (macrobiotica), and more!


You’ll learn:

  • If the Costa Rican healthcare system could meet your needs and 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.

Prices: $650 for a couple, $550 for a single.
Please contact us if you are interested in booking a tour. Space is limited.

Related Articles:


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What’s New on the Website

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