CCSS-Caja Costarricense de Seguro Social
An alternative to the INS plan is the CCSS plan. (Caja Costarricense de Seguro Social) This is the government medical plan that most Costa Ricans have. The plan covers pre-existing conditions, doctor visits, prescription drugs, examinations, hospitalization, dental and eyes. There is no limit on annual amounts paid out by the plan. A doctor and clinic is assigned to the patient. Lines and the processes can be long, but you will get decent care!
The cost is very reasonable – about $37.00 per month for a family where the principal insured person is over 55 years of age, and $58.00 per month where the principal insured is under the age of 55. For those under 55 there is a compulsory pension fund payment in the premium. Family includes spouse and dependants under the age of 18 years. The prices quoted are from 2004 and have likely gone up slightly.
Insurance through CCSS Requires Costa Rican Residency.
You CAN have both INS and CCSS! Many people have both.
Also, many doctors in the private hospitals are CCSS physicians and can often arrange billing through CCSS.
Filed under: Health care in Costa Rica, Insurance in Costa Rica
In order to obtain any type of residency in Costa Rica, one is required to obtain at least voluntary medical insurance with the Caja de Seguro Social So why not use its clinics and hospitals?
My wife was diagnosed with cervical cancer and treated as an outpatient in the Caja was and very happy with the outcome, with no trace of a tumor at her third, post-treatment check-up.
Shortly thereafter, she was dignosed with an intestinal oclusion, said to have been caused by over-radiation during her cancer treatment. This was re-confirmed after a surgery to remove one meter of lower intestine rendered useless, while the condition of the remainder was said to be poor but could recover. A “temporary” ostomy was performed and a second procedure planned to re-conect the digestive system in a four to six week period.
Just eleven days after surgery my wife was sent home. Her surgeon was not happy with this, and emphasized the importance of returning her through Emergencias if anything went wrong. After two days, due to a crisis we returned her and she spent a traumatic night on a gurney in the passageways of Emergencias, until being sent to a ward next day.
Her condition stabilized although gradually, as she was being treated for abdominal infection with anti-biotics and on the Thursday before Semana Santa, the surgeon announced he would install a catheter to feed her, in order that she would lose no more weight. He said she would need to remain hospitalized for a total of two more months. He then went on vacation.
The following Monday, instead of a catheter being installed, a female doctor removed my wife’s intra-veinous drip and told her she would go home that day. Alarmed, my wife called me and I spoke with the Jefatura, where the same information was given to me. Although finally she was not sent home, she was severely dehydrated during the following week despite my protests to nurses and to
those in charge. When the surgeon returned on the Tuesday after Semana Santa, he was horrified at his patient’s deteriorated and dehydrated condition and by the unbelievable amount of weight she had lost. Either he had left no details of his plan for his patient, or others simply ignored them.
The catheter then was finally installed, my wife stabilized once more but then started to have severe fevers and it was established that the catheter was infected and was the cause. Yet more weight was lost and her immune system was reduced to zero by the constant use of anti-biotics. A replacement catheter was installed but the infected one was not removed until some days later, such that the infection and fevers continued to consume my wife.
When we noticed that the second catheter had been disconnected, we were informed that it was feeding a resistent bacteria that she had acquired in the hospital and that her chances of survival were minimal, due to both her reduced weight and compromised immune system. They were correct and my wife died five days later, with múltiple opportunist infections accompanied by massive fever.
A total failure to coordinate and manage her treatment robbed my wife of the chance to survive. There was on the part of some of the nurses, a clear expression of not caring and of a strong distain for foreigners. My wife was even afraid of some of them, for the rough manner in which they treated her. Also, surprisingly not one of the people who took her many blood samples ever used gloves.
The way in which her Death Certificate was written, in an almost illegible scribble, was a final gesture of contempt, just as one might crumple and toss away a badly drafted document. Her untimely death and their failure meant absolutely nothing to any of those involved, only to their victim, my sweet little wife who fought so valiently for her life against all their errors and incompetence, and to her heartbroken and insulted family.
Yes, we are required to enroll in the Caja but use the services at your peril. The careless attitude of the Tico rules therein and those to whom I have spoken about this, just say you have to accept it like all the other shortcomings that reflect their sad philosophy. Everything is after all God’s will and he gives us the strength to carry on. There is no need to deal with anything, just like everyday life here.