Welcome to our Retire For Less In Costa Rica Newsletter
In This Issue:
- Using the Caja’s Online Appointment System
- Integration – The Path to New Adventures
- Featured Property in Lake Arenal: Best Deal on Lovely Spanish-Style Home in Tranquil Setting-$110,000
- Cooking in Costa Rica: An Expat’s Guide to Buying Groceries, Cooking, and Eating in Costa Rica
- Our Ultimate CR Healthcare Tour
Change sometimes comes slowly in Costa Rica, but eventually, it does come. Such is the case with the Caja. Back in July 2014, the Tico Times published an article about changes to the public healthcare system which would allow patients to schedule their appointments online. Here is an excerpt of the article:
Good news for users of Costa Rica’s public health care system: Starting in August, the Social Security System, or Caja, will have a new link on their website (www.ccss.sa.cr) for patients to schedule appointments online. In a first stage of the project, the digital service will allow patients to make appointments at 40 of the Caja’s 103 hospitals and community clinics, or EBAIS, throughout the country. The remaining hospitals and clinics will be brought online shortly after, according to José Manuel Zamora, a coordinator of the Caja’s Digital Medical Records project. Read the entire article here: http://www.ticotimes.net/2014/07/30/public-hospitals-to-offer-online-appointment-scheduling-in-august.”
At the time, Paul and I were living in the country, outside of San Ramón. Our EBAIS (local clinic) didn’t even have a telephone, let alone a computer. So online appointments, we knew, wouldn’t apply to us, at least for a long time.
In January of 2017, we moved to downtown San Ramón. When we moved, our local clinic changed to one downtown, located right across the street from the hospital. Still, we couldn’t make appointments online. But in August, when I went in to try to see the doctor, I noticed that things had changed. Normally, we would just show up at the EBAIS, see the receptionist, and then wait until the doctor could see us. Sometimes the wait was an hour, sometimes several hours. But this time, I noticed a sign on the wall with information about making appointments online. Here’s the English translation: “Get your web appointment. Request, cancel, and reschedule your EBAIS appointment with only one click at the following location: https://edus.ccss.sa.cr/eduscitasweb/. Now we modernize to provide you with a better service.”
So recently, when I needed to see the doctor again, I tried the online system. There are, however, a couple of steps to the process.
Registering With the Web Appointments System
First off, you must register with the online system. For this you will need two things: your carnet (Caja intentification card) and an email address on file with CCSS. When you go to the appointment system website, this is the first screen you will see:
If this is your first time, you would click the blue “Registrese” button (you could also click the “Registrarse” button in the upper right corner of the screen) in order to register. This will bring you to the registration screen:
The first box gives you two drop-down choices. Be sure to select “Extranjero” (foreigner). In the second box, enter your carnet number. It will be a 10-digit number, most likely preceded by a “7/” which designates you as a foreigner. So, you would enter the 10 digits which follow the “/.” Then, click the “Continuar” button to process your registration.
If all is well, you will receive an email which says, “Bienvenido al sistema Servicio Citas Web y APP EDUS (SCWB). Ingrese al siguiente enlace para establecer una contraseña de acceso al sistema: (link). Muchas gracias.” Translation: “Welcome to Appointment Web service system and APP EDUS (SCWB). Enter the following link to set a password to access the system: (link). Thank you very much.” Just clink on the link provided and set your password.
You will then get another email with the following confirmation: “Por este medio se le informa que se le han otorgado permisos para ingresar a la aplicación Servicio Citas Web y APP EDUS(SCWB), que está disponible en la plataforma de la Caja Costarricense de Seguro Social de Costa Rica. Para iniciar sesión en la aplicación debe utilizar los credenciales correspondientes al momento del registro:
Tipo usuario: Extranjero
Nombre usuario: XXXXXXXXXX
Contraseña: No mostrada por seguridad
Se le recuerda que su usuario y contraseña son de uso personal. No debe compartirlos con otras personas.
Módulo Integrado de Seguridad (MISE)”
Translation: “Hereby inform you that it has been granted permission to enter the Appointment Service and APP EDUS Web application (SCWB), which is available on the platform of the Costa Rican Social Security of Costa Rica. To log into the application must use the credentials for the time of registration:
User Type: Foreign
Username: (Your 10-digit carnet#)
Password: Not shown for security reasons
Please keep in mind that your username and password are for personal use. You should not share them with others.
Integrated Security Module (MISE)”
If there was a problem with your registration, you won’t receive the confirmation emails. The problem might be that you don’t have an email address on file. That’s what happened when I tried to register Paul into the system. The solution was to go to our local EBAIS, explain the problem, and give them Paul’s email address. Once they entered it in the system, I was able to go home and complete Paul’s registration.
Scheduling Appointment with the Web Appointments System
When you want to make an appointment online, you will go to the appointment website and click “Accesar” in the upper right corner.
This takes you to the login screen, where you will select “Extranjero” and enter your carnet number and password:
Then click “Iniciar Sesión” (Begin Session). This will bring you to a screen where you can enter the date you would like the appointment (usually the next day or later). Once you have selected the date, a list of available appointment times will appear below. Just check the time you would like and schedule it. As a confirmation, you will receive an email to confirm your appointment, including the date, time, EBAIS, and doctor.
One thing to remember about scheduling appointments is that you don’t have a choice of doctors or clinics. When you sign up for the Caja, you are assigned to an EBAIS (local clinic) based on where you live. Each EBAIS has a doctor assigned, however the actual doctor you see may vary. If the doctor assigned is on vacation or not there for other reasons, there will be a substitute doctor.
Going to Your Appointment
On the date of your appointment, plan to arrive about 15 minutes prior to the scheduled time. Go to the receptionist at your EBAIS and tell her you have an appointment. She will most likely have you on a list and will also have your expediente (patient file). If your file isn’t on her desk, she will send you to Archivo (Archives) to request it.
Next stop is to see the nurse. You will wait outside the nurse’s office until he/she calls your name. When it’s your turn, they will ask why you are there and take your blood pressure and weight. Then, it’s off to wait outside the doctor’s office until your name is called.
On my recent visit, I had made the appointment the day before. From the time I showed up for my appointment to the time I was finished with the doctor, it took less than one hour. The online appointment system allows for a much greater level of efficiency than before. We will definitely keep using it in the future!
- Costa Rica’s Caja: How it Works
- The EBAIS – Where Healthcare Starts
- New Development: Make Caja Appointments by Phone
- Our Ultimate Healthcare Tour of Costa Rica
When you move to a foreign country, many things will be different than in your home country. The people may speak a different language, their customs and food won’t be the same as back home. They may look different, and the way they do things might not make sense to you. You may be tempted to think that your ways, your customs, are superior and that this new land and their ways just don’t measure up. If so, you may choose to live in a community of people just like you, where you can speak your own language, both literally and figuratively. This is a perfectly natural way of dealing with the unknown. But, by not integrating into the new culture, you may be cheating yourself. Learning and experiencing the differences of living in another culture can be a great adventure.
Integration doesn’t have to be all or nothing; it’s really a continuum. On one end of the spectrum, you will find expats who move to a foreign country but choose to live in “gringo enclaves.” Their experience with the locals may be limited to their housekeeper and gardener. They shop almost exclusively at the upscale markets that carry the imported products that they are used to from back home. They get together with others from their own part of the world for cocktails and to discuss how “they” do everything wrong here. They don’t take public transportation, nor do they use the public hospitals. They only speak their native tongue and refuse to learn the local language. In fact, they don’t understand why everyone just doesn’t speak English. Their experience of the culture is purely tangential and they make every effort to preserve their own habits and customs. They live in a self-imposed though usually high-end “ghetto” of sorts, where it is safe and familiar and nothing out of the ordinary is required of them. In a sense, they tried to take their lives back home and transplant them, intact, somewhere else.
On the other end of the spectrum are the expats who choose to immerse themselves in the local culture. They choose places to live where there are not large groups of expats, and in fact, may not socialize much with fellow expats. They learn the language and develop friendships with their neighbors. They take part in community events, contributing their time, energy, and, perhaps, money in local causes and activities. They are invited to their neighbors’ birthday parties, weddings, and holiday celebrations. They shop local and have discovered lots of new favorite things.
And in between the two ends of the spectrum, there are all the other degrees of integration. It’s not all or nothing. You can take small steps. But to integrate into a new culture requires a certain degree of humility. You have to be willing to accept that different doesn’t necessarily mean inferior and that your way of doing things isn’t the only way, and might not be the best way in the local culture.
And it also requires some courage. As Paul always says, living in a foreign country can be the richest, most rewarding experience of your life, but you have to let it. It can be an adventure if you are willing to learn what the new culture can teach you. You have to be willing to be like a child again and to learn from everything around you. You have to be willing to try to speak foreign words and get over your fear of looking foolish. Start with basic greetings. Smile at people you pass in the streets and shopkeepers with whom you do business. Look for common ground. And remember, you are the foreigner here. You are the one with the obligation to try to fit in, adapt, and maybe even contribute to your new neighbors.
The Free Dictionary defines integration as “the bringing of people of different racial or ethnic groups into unrestricted and equal association.” To me, unrestricted means without barriers. Language can be one of those barriers to integration, but it doesn’t have to be a permanent one. Our friends, Tom and Marcia, moved from the U.S. to a small village in the mountains of Costa Rica where they are the only expats. They are learning Spanish and, while their language skills are far from perfect, they don’t let it stop them from trying to communicate. And they are rewarded by a richer experience and the appreciation of their new friends for their efforts. “Be more than a spectator,” says Tom. “Join in…Don’t just study Spanish, speak it! It’s natural to be afraid of making a mistake, but get over it and just speak…When you don’t understand, just say so. Don’t be embarrassed or afraid. You will make a lot of mistakes, but it won’t be long until people are praising how much you understand…If all else fails a shrug and a smile always works.” After almost nine years of living in Costa Rica, Paul and I are still taking Spanish lessons. It’s a process; as they say here, poco a poco (little by little). We are nowhere close to being fluent. But we didn’t come to another country to have only English-speaking friends. We are at the point where we do have Tico friends and can carry on conversations in Spanish. We don’t understand everything, but can usually get the general idea of what they are saying.
So, my best advice is to resist the temptation to be ethnocentric – try not to judge this new culture by the values and standards of your home culture. Learn some Spanish. Get to know some Ticos. Be courageous and humble. And have the time of your life!
- On Integration: Living in Costa Rica, by Tom Bunker
- 10 Ways to Fit In When You Retire in Costa Rica, by Tom Bunker
Featured Property in Lake Arenal: Best Deal on Lovely Spanish-Style Home in Tranquil Setting-$110,000
We recently learned about this property for sale and wanted to pass it on as a great deal. Originally priced at $275,000, this home is now part of an estate sale and is being sold by the family at only $110,000 USD. (RFLCR Note: After publication, we learned that the sale price on this house was incorrect. Additionally, there is a problem with communication with the legal owner; we have therefore removed it from our website.)
Location: Nuevo Arenal
1,947 square feet
Acreage: .7 acres ( 2913 m2)
Price: $110,000 USD
This lovely home with 2.5 bedrooms and 2.5 bathrooms sits on a lot surrounded by enclosing green palms and trees. There is a gurgling stream with its calming sound at the front edge of property which adds to the tranquility. There are many tropical birds and monkeys that visit this nature reserve type surrounding.
The house is comfortably furnished and ready to move into. It has a fireplace that adds to the romance of the home. There is also a laundry room with a washer, dryer and hot water tank for the whole house. The kitchen has a large refrigerator and a gas stove which many people prefer. The dining room is in a separate cove under the cupola and the living room is open, looking out to the patio where often the french double doors stay open to bring the 70F. Year round climate indoors and shared. It has a charming mission tile roof and the second floor room in the large room sized cupola is presently being used as an office but also has a double decker bed in case of extra guests. The attached enhoused garage is connected to a separate house entrance for convenience.
There are two bedrooms and two bathrooms plus a guest bathroom on the first floor, with both bedrooms facing the green outdoor surroundings. The front covered patio is seen from the living room through the Spanish wrought iron grill work which encloses all the exposed doors and windows as typical Spanish colonial home decoration as well as strong security if you are away from home. There is a deep swimming pool to the side opposite the entrance with its own pool equipment bodega including everything necessary to keep it functioning. A working alarm system is installed.
The community of homes in this development is one of the nicest and oldest in Arenal, with all homes having large private lots and placed so that each has privacy. It is very beautiful and friendly, with a mix of Ex-Pats from North America, Canada and also Costa Ricans.
Since we are only a 1.5 hour drive on all paved roads from the major capital city of Guanacaste Province of which we are a part, the fast growing major city is easier to get to than to the busy city of San Jose which is a longer drive. Most of the same businesses and medical facilities in San Jose have sub-offices here for the growing beach dwellers. It is also 90 minutes from the Liberia International Airport so easy for travelers to come and go.
Property: Ref # 214
Click here to check out our other properties under $150,000 and read about what to do before you buy.
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:
- Meat & Poultry
- Fish & Seafood
- Grains, Nuts, Seeds, & Baking Ingredients
- Dairy & Eggs, Refrigerated & Frozen Foods
- Beans, Canned & Prepared Foods
- Herbs, Spices, & Seasonings
- 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.
- 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.
The Kindle version is available now on Amazon.com. If you don’t have a Kindle, you can download the Kindle app for your iPad or computer at this link. A print version is in the works; I will let you know as soon as it is published. In the meantime, you can buy the Kindle version through this link:
I hope you enjoy my book and find it useful!
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 arranged 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.”
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.
- At least two private hospitals in San Jose area
- Hospital Mexico, the largest and best public hospital (they even do open heart surgeries there)
- 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!
- 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.
- Paul Gets a CAT Scan Through the Caja
- Integration 102 – Speaking Up at the Hospital
- Waiting to See the Doctor, by Jo Stuart
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Check out our newest posts on www.retireforlessincostarica.com:
- Dental Tourism in Costa Rica: My Experience – Part 2, by Vikki Riggle
- Change Your Name Before Moving To Costa Rica, by Rob Evans
- In the Mailbag – Suspending Caja Fees, Body Donation, Simplicity, and Thoughts About Paradise
- Our Costa Rica Cost of Living, by Rob Evans
- End of life Issues – Burial and Cremation in Costa Rica
- End of Life Issues – Body Donation in Costa Rica, by Judy Kerr
- Our August 2017 Costa Rica Cost of Living
- Paul’s Money Saving Tip: Find Reasonably Priced Housing
- Our 2016 Annual Cost of Living in Costa Rica Summary