When it comes to health insurance in any country, it pays to be prepared. After all, you never know what costs you might be facing, until a time comes when you are ill or injured and require treatment. And as with any area of life, being presented with an unexpected bill is never a good thing!Healthcare can be particularly difficult to plan for, especially as hospitals and doctors’ surgeries don’t tend to advertise their costs. But just because you’re unsure of an exact figure to set aside, that doesn’t mean you can’t be practical and put something in place so that you’re prepared for the future.
Taking out health insurance is one of the best ways to plan ahead.
Should I Get Private Health Insurance?
The decision as to whether you should get private health insurance is completely your own and will depend upon your individual circumstances. For example, if you have a pre-existing medical condition it can be worthwhile to have private health insurance in place to ensure that you’re covered for all treatments relating to that condition.
But there are certain instances, such as emergencies, where you’ll be taken straight to hospital and treated under the public health service anyway. In Costa Rica, the majority of people have coverage through the government-run healthcare system known as Caja, and it is this system that will treat you in an emergency.
There isn’t a national benefit package available through Caja, but the system operates through a network of hospitals and clinics throughout Costa Rica and the premise is simple—it covers everything which is deemed necessary. This includes GP visits, ambulatory care, hospital care and even certain prescriptions—and as a result, the public healthcare system covers an extensive list of conditions (including those which were pre-existing), ensuring that the majority of your healthcare needs are taken care of.
Because of this, Caja is able to provide residents with low-cost services for medical treatment. Treatment through Caja is not available to tourists or visitors. It is only available to those who are considered residents of Costa Rica—something you’ll be eligible for if you’re a resident or a pensioner, and will automatically be eligible for once you start contributing to Costa Rica’s economy through monthly contributions.
The contributions are based on your monthly earnings and will cost between 7-11% of your pre-tax pay. Once this deductible is paid, you’ll have access to consultations, checkups, prescriptions and more.
Because this system isn’t available to you until you’re classed as a resident, it’s important to ensure you have a back-up plan when you first arrive—and that’s where private health insurance comes in.
You can get private health insurance through a personal plan or through your employer, and there are a variety of insurers and policies available for you to choose from.
Most policies offer generic coverage levels, but you can often tailor these to suit your individual requirements. It’s important to note that some pre-existing conditions, such as heart attacks or surgeries, may increase your premium as this care tends to be considered a medium to high risk, and requires more extensive care.
Certain other elements, such as your age, will also affect your premium. This is because from an insurer’s perspective, the younger people are, the less likely they are to have health conditions, which means fewer treatments and fewer visits to the doctor’s office. Unfortunately, this cannot be changed—but each insurer is different and there are providers available which target certain demographics, so you should be able to find a good deal.
Because each policy can be tailored to individuals to reflect their unique needs, there are factors to consider when trying to keep your insurance costs down.
Area of Residence
Insurance companies use a variety of factors to determine how much a person’s health insurance may cost. One such factor is where you live. This is because insurers look at statistical data in local areas to see if there are common conditions which happen as a result of a shared climate, including both cultural and environmental factors.
Family Medical History
Sometimes insurers will want to know about your family history before they will provide you with a plan. This is because many conditions are hereditary, meaning that you have an increased likelihood of contracting a condition that one of your close relatives had. You might need to pay an increased premium if conditions such as heart disease or certain types of cancer run in your family.
Professional Occupation
Our jobs affect so many elements of our lives, and they are also taken into consideration as a factor in health insurance premiums. This is because each job comes with its own set of risks.
For example, people who work in sedentary jobs with limited movement each day, such as office workers, may suffer from repetitive strain injuries. Those who work as athletes tend to have a higher injury risk rate, and those who work near hazardous materials or chemicals will be at higher risk for certain diseases. From an insurer’s perspective, therefore, certain professions will be considered higher risk and will face increased premiums as a result.
Body Mass Index (BMI)
Weight is by no means a representation of somebody’s health. However, insurers still use it as a variable for calculating coverage costs due to the associated risks which come from having a high BMI, such as sleep apnea, joint problems or the risk of diabetes.
Smoking
Due to cigarettes increasing the risk of cancer and other ailments, if you smoke (or have only recently stopped) your insurance premium will be higher than those who have never smoked. This is because it can take a long time to recover from the effects of smoking—even if it never caused you to develop an illness.
Because of this, insurance premiums will either be higher or coverage may be denied altogether. Each provider has a different policy. However, there are many that do cover smoking and will also support you in quitting smoking if you want to, by providing additional support and resources such as patches or gum for those who are looking to quit.
Pre-Existing Medical History
Insurers will ask certain questions regarding your pre-existing medical history to get a broader understanding of how your health is overall. Previous conditions or illnesses play a huge part in how much your premium will cost as the policy may be deemed as high risk, and certain conditions can be costly to treat or manage.
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