marvinlh
2/7/2017 22:06 EST
Hi, my name is Marvin and I am new to the Costa Rica forum. I was wondering if anyone else has had a similar experience to the following: on Saturday, Jan 28th, I had to be taken to the local hospital in San Vito (southern Costa Rica) by Roja Cruz and spent 9 days there getting the swelling in my leg down (edema) by way of inflammation injections and saline solutions. Around day 5 or 6, I noticed that my total costs were averaging over USD $1500 each day and tried to get released then as I didn't have insurance, but the doctors advised against it until they finally agreed on the 9th day. Right now, I'm contesting and trying to negotiate downward the USD $15,481 I was ultimately billed, but have little experience as to what they will accept to settle things. Previously, I've had 2 other good experiences with low-cost care going to other public hospitals. Please, no focus on my not having insurance or getting CAJA as this is the works. Any idea what happened here, and what the lowest amount this hospital would settle for? Thanks, Marvin
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Pombinha
2/8/2017 02:07 EST
Father, in the Name of Jesus I pray for Marvin and for this situation.
Have mercy on him!
The Bible says in Proverbs 21:.1:
"The king's heart is in the hand of the Lord, as the rivers of water: he directs it wherever he pleases"
Lord, take the hearts of those Doctors and Hospital administrators in Your hand and turn them in a way that will be favorable to Marvin.
In Jesus Name I pray.Amen.
I Praise You Lord!
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carolvaughn
2/8/2017 08:46 EST
Try to negotiate with the hospital. Take
someone who speaks good Spanish
with you. Be humble. Good luck!
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freedom16
2/27/2017 11:46 EST
Is $1500 a day an average cost for a hospital stay? Did they require any money or a credit card before you were released?
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marvinlh
2/27/2017 13:37 EST
No, the $1500/day rate is not the average cost for a night in the hospital. A forum member in a private message gave me advice to not pay the bill (most Costa Ricans don't), as Costa Rica law states that expensive medical bills shall not cause a hardship on Costa Rican property owners. I went to the hospital, and told them I had limited income (which was true) and could not afford to pay the $15,481 bill, just to see what they said. The clerk then started to process my bill to say "nothing remaining owed", when I stopped him and said I would pay 1/8 of the amount due, as I wanted to be fair in compensating the hospital for the services I did receive. So, I settled for $1700 to $1800 of the original amount due. The forum member I talked to said the hospitals in Costa Rica are well aware of the harsh US legal system and what happens when people don't pay their bills here, and will use this knowledge to go ahead and try overbilling a patient for $15k (as an example) as sometimes the patient will not question the bill and pay the full amount. In another words, nothing ventured, nothing gained so they might as well try and they might get lucky. The hospital gave me 5 days to contest the bill, I believe I gave them my credit card as a means of good faith, but they didn't ask for it prior to being released.
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Kohl
2/27/2017 13:54 EST
A few years ago we paid around the $1500 PN, for the hospital plus the fee for the surgeon.
We had to pay half of the expected bill 'up front' on admission and the staff never left our side as we were getting ready to leave, until the total bill was paid.
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Kohl
2/27/2017 15:10 EST
Marvinlh's bill was with CAJA so I don't think you would get off so easy, trying to negotiate with one of the large private facilities.
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freedom16
2/27/2017 16:09 EST
So the ideas of reasonable health care are not so true. If hospitalization is required and they have your credit card seems like you need to pay.
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DRThomas
2/27/2017 16:30 EST
I lived in CR for around 6.5 years, and I heard similar stories. A fall that injured a knee turned into an infection that led to a bill of about USD$17,000 at a very well known hospital in San José. The patient and his adult offspring refused to pay (refused, not couldn't) so the bill was passed to the co-signer, the owner of the B&B where he had been staying. I live in Guatemala now, and the same stories still come to my attention there.
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linlewhammond
2/27/2017 16:59 EST
I don't know what happened in your case, but would like to relate what a man told my husband today in a cafe.
He said he was not feeling well, and went to doc in the US, who sent him to hospital and put in 2 stents and was charged $55,000.
Then he returned to Costa Rica, and began to feel bad again. He went to doc in Grecia, who sent him to CIMA hospital in ambulance. The doctor was waiting for him when he arrived. The hospital performed the exact same operation for $1800. This time he feels good.
So perhaps for some bad experiences, there are also good ones.
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freedom16
2/27/2017 17:35 EST
The issue is the surprise billing. If entered in an emergency and credit card is required at some point you are subject to bills that you have no control over. Negotiating is not really an option and payment can be billed for any amount. Guess you can dispute with your bank but that is another thing. If a hospital stay was scheduled in advance from what I read online the top hospitals charge $400 or so a day.
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Kohl
2/27/2017 18:00 EST
Plus all the 'add on's' including the surgeon, anesthesiologist, blood tests, x-rays, MRI, CT Scan etc.. 8-(
This why some expats choose to go 'private' for the diagnosis which can take a long time through CAJA, then use CAJA facilities for the actual treatment.
This is what we have chosen to do, multiple times.
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freedom16
2/27/2017 18:06 EST
It just seems to me excluding CAJA which may not be available yet for many is not inexpensive in Costa Rica, Just trying to sort out the facts.
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marvinlh
2/27/2017 18:44 EST
The surprise billing was what threw me off-balance too, as I wasn't expecting it.
In February 2016, I experienced an extremely sharp pain in my left leg from my hip to ankle when moving from Colorado to Costa Rica, and I was sure I was going to need surgery. I avoided the US doctors, and in May 2016 I visited the hospital in San Isidro as the leg still wasn't healing.
After taking tests, the doctor diagnosed that I had a severe case of sciatica within 2 hours. Then it was a process of getting injections and medications, clearing admin every time I went somewhere, getting final clearance and then getting my prescription meds. Total elapsed time was nearly 9 hours after getting there at 10 am, but my total bill was only USD $168. And I was happy as the problem was figured out, and at low cost.
A couple of more things as it relates to surprise billings, and one that's probably borderline politically incorrect, but I'm going to say it anyway.
In Costa Rica, people coming in from the US (and Canada) are perceived as having lots of money by Costa Ricans. And as a result, there may be an increased emphasis to raise prices (we've know of the price lists set for Ticos & Ticas, and then there's the second price list for tourists, etc.). I could sense a little of this behind my initial hospital bill.
Second, healthcare in Costa Rica is quickly changing with new, private hospitals moving in. Also, the existing public health hospitals are not in good condition financially, as many people cannot afford or choose not to pay for their medical services, and I believe I heard that CAJA is having to raise their monthly rates to compensate for this.
I guess the point I'm trying to make is that there is no easy, one-solution-fits-all method in trying to bottom-line Costa Rican healthcare. Each person is going to have to do their own research on what kind of healthcare they want (public or private), knowing what type of existing care facility is in their town (public or private), perhaps consider the benefits of enrolling into CAJA (under Costa Rica's Social Security program), or as Kohl suggests, have a combination private/CAJA care coverage set up. Just knowing one's options more will lessen the surprise factor.
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GenXpat2021
2/27/2017 19:14 EST
Indeed unfortunate. Is this sort of thing merely one-off?
In U.S. you might be bankrupt for life, w/inno assistance! Hope your well, prepared I wish you the best
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Pombinha
2/28/2017 04:33 EST
Marvinlh,
The same way I prayed for you publicly in this blog now I want to say:
Father God I give you thanks in the Name of Jesus that Marvinlh didn't have to pay that huge bill.
I praise You for this outcome,Lord!
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linlewhammond
2/28/2017 09:03 EST
The pain in your leg and location sounds like sciatica. Got rid of mine with chiropractor which a good chiro can do for a fraction of time and cost.
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marvinlh
2/28/2017 09:59 EST
Thanks for the advice linlewhammond, I eventually got over my sciatica with exercise and applying pressure on certain areas of the leg (similar to acupuncture) to loosen the muscle/nerve. Never imagined the amount of pain that tweaked nerve could cause.
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lindyluvsCR
2/28/2017 12:34 EST
With sciatica, I've had two times. can barely walk and in extreme pain. I've known people that have gone to regular doctors for it, and end up having unnecessary operations, or other crazy ineffective solutions. A good chiro can get rid of in very few sessions for little money, and vast relief in the first treatment alone. I know, I've been there. And has also gotten rid of other ailments I didn't even ask for in the process.
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jim42
3/1/2017 18:59 EST
Just my 2 cents.....you are gringo therefore you are wealthy.........they want your money. I resided in CR from 04-08 and I wouldn't even visit that country. My last 12 vacations have been to Mexico and I felt much, much safer and I didn't get ripped off,
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jim42
3/1/2017 19:06 EST
Meaning I wouldn't visit CR again "even if it was a free vacation".......
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