Welcome to our Retire For Less In Costa Rica Newsletter
In This Issue:
- What’s Up With the Yeatmans? CT Scan, Cancer, and the Caja-Part 2
- Our August 2018 Costa Rica Cost of Living
- What Are the Economies With the Most (and Least) Efficient Health Care?
- Featured Property in Lake Arenal: Lovely, Large Home in Las Palmaras de Arenal-$150,000
- Cooking in Costa Rica: An Expat’s Guide to Buying Groceries, Cooking, and Eating in Costa Rica
- Our Ultimate CR Healthcare Tour
As we told you in our last newsletter, Paul came home recently from two weeks in the hospital after having surgery for kidney cancer. Here is a video we shot the day he was to head to the hospital, telling the story-to-date. We hope that you will find it interesting, not only the specifics about Paul’s situation, but about how the Caja system worked for us.
A couple of hours after making this video on Friday, July 27th, we went to the hospital by bus with a couple of our friends along to lend support. We were told to arrive after 4:00 pm at Hospital San Rafael in Alajuela, an hour’s bus ride away. We reported to the admissions office shortly around 4:00 pm, only to be told that there was a mistake, they didn’t have a bed for Paul after all, and we should return home to await another call. So after many weeks of the anxiety of waiting, we got on the next bus and went home to San Ramón. We later learned that admitting patients to a Caja hospital is a balancing act. They need to balance emergencies with urgent surgeries (like Paul’s). People waiting for routine surgeries may have to wait many months, or even years, for them to be scheduled.
Four days later, on Tuesday, July 31st, we got the long-awaited phone call and headed for the hospital again. This time, Paul was admitted and our Caja hospital experience began.
Since Paul was in the hospital for the first part of the month (until the 13th of August when he was released), our spending in several categories was not typical.
Transportation – $159.50
We live in San Ramón and Paul was in Hospital San Rafaél in Alajuela, about 45 minutes away by car. Though we have a car, it has a manual transmission and I am not comfortable driving it. Since we live in town, it was simpler to take the bus to the hospital each day. I walked about four blocks to the bus station in San Ramón, caught the bus to the station Alajuela which was the first stop. Then, I walked to the hospital which was about three blocks from the bus station. In the evenings, I would reverse the trip to return home. When one of Paul’s nurses found out that I traveled back and forth every day, she said, “Qué amor!” I replied, “Where else would I be?” We all smiled and Paul said he felt 10 feet tall. “I’m a lucky guy,” he said.
On 11 of the 13 days in August that Paul was in the hospital, I took the bus round-trip at a cost of $5.15 per day. On two of the days — the day of his surgery and the day he was released — I took the bus one-way only at a cost of $2.58 (1,445 colones) per day. Since Paul’s surgery was scheduled at 7:15am, I knew I needed to get to the hospital very early in order to be sure I could spend some time with him before his surgery. I hired a local Uber driver to pick me up at 4:30am and take me to the hospital for a fee of 20,000 colones ($35.65). On the day that Paul was released, friends picked us up and brought us home.
In addition to the public transportation, we also had one fill-up in August ($61.67) with premium gasoline. Paul hasn’t driven since before the surgery but when we need to go anywhere by car, our friend, Bill, drives us in our car.
Groceries – $324.80
I’m actually surprised that our grocery bill came in as high as it did. I did very little actual cooking while Paul was in the hospital. But once he came home, I stocked up on healthy foods and cooked our meals every day. Also, our friend, Bill, came to stay with us on the 14th to take care of our cats and stay in our apartment during our planned trip to Mexico (which was postponed a month due to Paul’s surgery), so that accounts for part of the spending. Also included in the total is lots of bottled water (about $30 worth) which I brought to Paul each day in the hospital and bought for myself as well.
Meals Out – $105.93
Once Paul was recovered enough to take short walks around town, we ate out a couple of times — once during the Festejos San Ramón, our town’s annual festival which lasts about 10 days. Having a meal of barbecued ribs with friends Lorca and Robert has become a yearly tradition. However, most of the meals out in August were during the time Paul was in the hospital and I ate either lunch or dinner out. Usually it was cafeteria food at the nearby Mas x Menos grocery store for lunch or chinese carry-out for dinner at a restaurant near the hospital, averaging about $5.00 per meal. I wasn’t allowed to bring food for myself into the hospital, and the only food I was allowed to bring in for Paul was fruit (which I had to get special permission to bring for him).
Healthcare – $219.27
About $60 of the total went to our monthly Caja payment and the pro-rated monthly amount for our MediSmart plan.
The rest went towards medications – two prescription medications we were taking, and a variety of cold meds for Paul. When the bed became available at the hospital, he had a terrible cold, but when a bed is free, you have to take it or who knows when the next one would become available. I brought him strong cold medicine (which we told the doctors about) and he took it for the first week or so he was in the hospital. Thankfully, his cold was gone before his surgery was scheduled.
Rent/Phone/Utilities – $845.48
Most of our expenses were normal in this category except for two:
First off, we had our apartment cleaned five times in August instead of the normal four because of how the days of the week fell during the month, so our housecleaning expenses are a bit higher than normal.
The other high expense was a complete surprise. Paul and I both have pre-paid (pay-as-you-go) phone service through Kolbi. Once he was in the hospital, there was no Internet available for him. We also kept in touch by phone or text during the hours we weren’t together in the hospital. No problem, we thought, we will just add money to our phones as needed. What we didn’t realize was how expensive that would turn out to be! Of the total $126.67 we spent on phone charges for the month, $107 was for extra data and phone charges during the two weeks Paul was in the hospital. As normal, about $18 was for our Vonage service to the States and Canada.
Personal Care and Clothing – $54.14
Once Paul was home from the hospital for about a week, he was ready to try the steps (our apartment is on the second floor) and venture out. One of his favorite things to do is to visit Mega Ropa, one of the many local ropa americana stores. (We featured it in our recent video, “A Walk Around Our Neighborhood.”) Of course, since I was with him, I shopped also and we both bought several items for about $5 each. Also, during the San Ramón festival, I bought myself one of the red and white “San Ramón: Tierra de las Poetas” t-shirts for 6,000 colones (less than $11 USD). There is a new design every year, always in the colors of our town, red and white. It’s fun to wear it during special events and holidays.
Vet/Pet Supplies – $22.42
Since we were stocked up on kitty litter, our only expenses for Tori and Laura this month were for cat food. (Expect to see an increase in this category next month with a change in food and visits for them both to the vet.)
Entertainment – $135.63
Most of the expense in this category ($99) was for the annual renewal of our subscription to FMTV (Food Matters TV), a streaming TV channel offering a variety of health and wellness programming including documentaries, guided programs, and other videos about healthy eating, yoga, meditation, cooking, etc.
Also, with Paul’s cancer diagnosis, we are looking for natural ways to prevent cancer in the future so I bought a couple of books on the subject, with probably more to follow.
And then there are our normal subscriptions for The Baltimore Sun online (our hometown paper, $1/month) and NetFlix ($11.65).
As usual, to help put things into perspective, here are our expenses for the previous two months. If you want more information about a particular month, just click on the graphic for that month below:
- A Walk Around Our Neighborhood (Video)
- Paul’s Monthly Tip to Live for Less in Costa Rica: Shop at Ropa Americana
Bloomberg just published it’s article, “These Are the Economies With the Most (and Least) Efficient Health Care,” stating that “The U.S. will cost you the most for treatment, both in absolute terms and relative to average incomes, while life expectancy of Americans — about 79 years — was exceeded by more than 25 countries and territories, according to an annual Bloomberg analysis in almost 200 economies.”
Coming in as the three countries with the most efficient healthcare were Hong Kong, Singapore, and Spain, respectively. Canada was rated at number 16, Mexico tied with China at number 20, and Costa Rica made the top 25 at number 25. The United Stated tied for 54th place with Azerbaijan.
The sources for this article included: World Bank, World Health Organization, UN Population Division, International Monetary Fund, Hong Kong Department of Health, Taiwan Ministry of Health and Welfare.
You can read the entire article and check out the ratings of 56 countries at the link below.
- “These Are the Economies With the Most (and Least) Efficient Health Care,” Bloomberg, September 19, 2018
Property: Ref # 303
Location: Nuevo Arenal
1,642 square feet
Acreage: .75 acres (3047 square meters)
Price: $150,000 USD
This lovely home is a true bargain with a wrap around porch on two sides in a quiet residential area of Nuevo Arenal. It is within walking distance of the town center. There are high ceilings with ceiling fans and large glass windows for good air flow and light. The kitchen is modern with granite counters and a spacious work area.
It has 3 Bedrooms and 2 Baths and a separate entranced office area used as a business office. There is a 2 car garage with a remote controlled door. The yard is 3/4 of an acre and private in back of the house.
There easily is room for another home on this property and is one of our best buys.
Property: Ref # 303
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.
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!
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.”
David and Donna H. recently too our healthcare tour and had this to say on one of the expat Facebook groups: Donna and I just finished the medical tour that Paul and Gloria (Retire For Less in Costa Rica) offer. It was excellent! Two days of information and tours around hospitals and clinics as well as educational and cultural centers and even information on some of the banking. The tour is designed to introduce a new arrival to the Costa Rican system of health care that includes, not just the body but the whole person. I highly recommend this tour to anyone that is new, or relatively new in country, especially to the people that live in and around the central valley. Paul taylors the two days to the groups needs as far as their ability, including any and all physical limitations, and his own experience and contacts with the people at the various institutions makes this tour extremely personable and pleasurable. It is a really great opportunity to learn more about the health care and how you can tailor it to your own needs, and learn more about what is available to enhance your experience while living in Costa Rica.”
We’ve lived in Costa Rica for over nine 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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What’s New on the Website
Check out our newest posts on www.retireforlessincostarica.com:
- Our July 2018 Costa Rica Cost of Living
- What’s Up With the Yeatmans? CT Scan, Cancer, and the Caja
- Our June 2018 Costa Rica Cost of Living
- PURA VIDA – Challenging the Ethnocentric Mind (A Documentary Short Film)
- A Walk Around Our Neighborhood (Video)
- 10 Tips on How to Thrive as an Expat in Costa Rica