Costa Rica Expat Forum - Concerned about CAJA 13% premium

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tecolote
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12/19/2013 00:08    
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Is it correct now that CR requires all permanent residents to pay 13% of their incomes for CAJA insurance (whether they want this or not)?

Does anyone know whether this means 13% of a couple's total annual income -- even if all of this income comes from outside CR? Do you have to pay 13% of all income -- including SS, pensions, investments, etc.?

Many thanks for clarifying!

PacificLots
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12/19/2013 09:05    
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It is 13% of the amount of income you specified when you applied for residency in Costa Rica. So if you showed income of $1000 per month per couple when you applied for residency, it is $130 per month to the Caja. If you showed $2000 per month, it is $260 per couple to the Caja. My Blue Cross Florida Blue policy is in front of me right now, covering two of us, in our 40's and 50's non smokers, with a

PacificLots
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12/19/2013 09:06    
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It is 13% of the amount of income you specified when you applied for residency in Costa Rica. So if you showed income of $1000 per month per couple when you applied for residency, it is $130 per month to the Caja. If you showed $2000 per month, it is $260 per couple to the Caja. My Blue Cross Florida Blue policy is in front of me right now, covering two of us, in our 40's and 50's non smokers, with a

PacificLots
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12/19/2013 09:09    
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sorry got cut off,
our policy with a $10,000 deducible (each person) has a monthly premium of $625. That policy does not pay a dime until I had to spend $10,000 in health care coverage. (okay so that will be the cost of having my blood pressure checked and looking down my throat) but do realize the cost of the Caja is SUPER CHEAP when you realize it includes healthcare. Go back to the states and see what you have to pay under Obamacare!

Kohl
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12/19/2013 09:57    
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Even if you have multiple pensions, you are only required to use what you declared for residency. And the percentage is from 10 -13%, so you can hope for the best...
CAJA in an emergency situation is a great thing to have even if you wish to use private facilities for your general health care.

tecolote
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1/3/2014 00:58    
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Thanks for the replies.

From what I've read about CAJA, its long waiting times, aging facilities, etc., it's hard -- at least from my perspective -- to justify having to pay nearly $300 a month, for a couple, for insurance my wife and I would not likely use.

Since we're retired, we need to compare what we presently pay for health coverage here in the U.S.: a little over a hundred a month each for Medicare, and zero premium for a Medicare Advantage plan that covers virtually everything with very low copays ($0 to see a primary care doctor, $20 for a specialist, $0 for lab work, no deductible, Rxs from $4/mo for Tier 1 drugs, etc.)

Of course there's a great deal more to life than health insurance, but it is undeniably one important factor, especially for retirees.

Costa Rica's decision to force all expat permanent residents to pay 10-13% of their stated incomes is, for us, and I think for a good many would-be expats, not an incentive to move there.

I wonder if this policy is due to CR's wish to limit the number of new expats. If not, it's going to accomplish that to some extent.

shermanwc
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1/3/2014 05:56    
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You have valid concerns. Dealing with health insurance was one of our most difficult tasks when we moved to CR in May of 2013. We've opted for a global private insurance policy with a high deductible that has limits or exclusions for several pre-existing conditions for my wife and I (but includes coverage in the USA). We will self-pay most costs for now, using the policy only for "major medical". We will not be eligible for Medicare for two more years, so we will likely re-evaluate when we can get Medicare.

We have applied for residency and will eventually have to pay into CAJA. We still plan to have private insurance, but some things that CAJA can be used for effectively are: prescription drugs (if approved), lab tests such as blood work, and emergency care.

CAJA is a bit like Social Security & Medicare in the USA in that you are required to pay into the system. But I agree that it is frustrating to be forced to pay for generally ineffective medical services, outside of emergency care.

I think that CR sees expats as a source that can be tapped for extra income into their system.

bluewind
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1/3/2014 18:25    
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I was considering a move to CR, but with this having to pay into a system that I will never use certainly makes a difference, especially in a country where the cost to live there keeps going up. Panama is now considering placing a tax on foreign earned income also. Looks like CA has decided a way make a lot of money is to sock it to expats. Really sad, because both countries are beautiful, but if I have to watch every dime I spend to just get by, it just isn't worth it.

LanaCR
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1/4/2014 16:25    
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For us in our late50th, private INS insurance is $100 for man and& 120 for a woman
Now some examples from the life Without any insurance in CR:
For example, I had to have blood work in July in a private lab 2 km from our place $ 80.00. Chest XRay &26, ECG- $ 20, including interpretation within 30 minutes. Small dermatological surgery the same day as appointment all together $200.
Dental is much cheaper then Canada or USA
For example, root canal $300 vs$ 1,000
We really believe that quality of services we have received also so much better and faster.

Kohl
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1/7/2014 08:06    
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Increase this month, to already established CAJA rates, have gone up, reportedly another 17%.

How this will effect a new resident, I have no idea.

positivlysmb
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1/9/2014 14:20    
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Under the ACA (affordable care act), I pay $36.85 per month, a one-time $500.00 deduct. After deduct., no charge for any medical service. I have decided against CR, and will now consider Panama. Please stay in CR.

Junebug
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1/12/2014 18:19    
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Kohl,

I'm a little confused by your statement. Are you saying the CAJA has gone up another 17% for those who already pay into the system? Can you post a link to this info? That would be very helpful. We know about the 13% which for us, as future rentistas, would be $325 (for a couple). Pretty steep. Another increase would probably be prohibitive for us in terms of living in CR.

Thanks.
June

Kohl
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1/13/2014 08:28    
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Sorry to say, there is no link announcing the raise. ...but on many forums, and by discussions in person, the fees have risen, just under 17%.
A new resident who received his resolution and cedula, as of Dec, paid one payment, then in Jan, his too, had gone up by the 17%.

shermanwc
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1/13/2014 09:01    
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Just to make sure I understand: the Caja premium has increased by 17% meaning 1.17 x 0.13 = 0.152. i.e. the new rate is 15.2% of income vs 17% of income?

Kohl
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1/13/2014 09:06    
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Since there was no article explaining the increase, all we have been able to find out is that Residents with existing accounts with CAJA, is that they have risen, just under 17% as of January 1st.

jwil1634
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1/13/2014 13:02    
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To echo Sherman's question, please clarify: Did the premium increase TO 17% or did it increase BY 17%??

jwil1634
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1/13/2014 13:02    
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To echo Sherman's question, please clarify: Did the premium increase TO 17% or did it increase BY 17%??

Kohl
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1/13/2014 13:43    
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If you are ALREADY in the system, the cost has increased by almost 17%.

It is IMPOSSIBLE to say 'exactly' what percentage, people will be charged, when they are eventually able to affiliate with CAJA, as the percentage rate, based on their income declaration, 'is all over the place'.

Kohl
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1/16/2014 08:59    
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On the local news yesterday, it was mentioned by a leading candidate for the upcoming election, that fixing CAJA's woes, is #2 on the election agenda.

It was also stated in a email to those also receive a CCSS IVM pension, that more of these large increases will occur of the next few years due to many not paying what they should.

Kohl
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1/16/2014 09:52    
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Article this morning in the TicoTimes, which doesn't clear up questions...or provide answers.

http://www.ticotimes.net/2014/01/15/change-in-calculation-of-monthly-deductions-confuses-cajas-insurance-holders

tecolote
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1/16/2014 22:34    
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I have to shake my head: After spending many, many hours over the past several years thinking seriously of moving to CR, reading books, forums, and more, the CAJA "premium" that expats are now being charged -- whether they want the service of not -- is quickly drawing a line through CR as a viable retirement destination for my wife and me.

The previous year's 13% of reported income is clearly variable at the discretion of the interested party, the government.

This fact makes retirement planning too uncertain for many: After the considerable expense of moving to CR, perhaps buying property, living through the time-consuming chore of an international move, it's very possible that in a few years, or less, the percentage charged to expats may rise and outdistance our means, or our willingness to pay through the nose for a service we don't want.

Costa Rica is being very short-sighted in their exploitative willingness to dig deeply into expat pockets for a medical service perhaps relatively few wish to have at the cost they must pay.

For my wife and me, the writing is on the CR wall, and we are reluctantly drawing a line through our Costa Rica dream.

naturechild
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1/20/2014 13:40    
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Pacific Lots, you may be unaware that your 'Health Care in Costa Rica" website page, is still quoting the old CAJA rates, of 2010 "... all expats must enroll and contribute to the CAJA system (about $37 - $55 per month per person, depending on age"
I see you have stated a more recent cost above, but sadly, it has risen a further 17%.

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