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@wri57

I love that!!!   Wow!!   Like Bermuda.   Plus, you don't have to worry about controlling the run-off from your rain gutters onto your yard because it all gets used.   That is one of my biggest 'projects' down here in CR... engineering the rain run-off from the roof... and making sure that low lying parts of the yard can drain somewhat.  We had 21 feet of rain here last year (where I am) and  we're still cleaning up from it.  3 of 7 bridges in my village were 'compromised'... so reconstrution and inconvenience is on-going... and one of the main highways near me still has one lane blocked where the side of a big hill slid down onto the road.  I'm thinking that the Engineers don't even know where to start with that mess...

The rains will start again in May... but it's pouring right now... April 10th...  an omen??   But all the rain makes this mountain paradise quite beautiful... and the drinking water is superb

Peace to you.

I arrived on Sunday and we've had quite a bit of rain already.

A Nicaraguan worker in a coffee plantation whom I encountered told me, in Spanish: "Rain is a blessing from God."

For their coffee and apple plantation, "Yes."

For those caught out in it, "Not so much."

I am trying to obtain medical coverage through MediSmart or other coverage such as Salud 360, INS, or Medicina Mixta, for some prescription drugs and other items, for pay-as-you-go coverage on a discounted system.

I just arrived and am not a permanent resident, but am here on a tourist visa (180 day, renewable).

Any wise counsel from those who have gone this route before me would be much appreciated.

BTW, I am living near Heredia in San Pablo de Barva's outskirtks, walking distance, downhill, from the town square, church, shops, and CLINIC.

@rainagain

A cistern will only hold so much and then you will still have an overflow problem. That's a lot of Sky Juice!

@wri57

Yep...  sometimes, after about a month of nothing but rain, I'll sit behind my house at night facing the mountains; when there's no traffic nor other human noises ... and just wait to hear trees fall up in the nearby foothills... it is eerie, but also, kind of beautiful.  First you hear some cracking, and then the bursting of wood and then a whoosh!!! ... followed by silence.  The ground is so wet and saturated that any imbalance is a recipe for disaster.  I think about the animals up there and how it may affect their lives... ??

In your current status as a tourist, you should have no problem obtaining travel insurance which will cover you here. You'll need to shop around.

MediSmart is a medical care discount program run out of Hospital Metropolitano. It's not conventional insurance coverage in any sense of the term. You are required to use MediSmart's enrolled service providers. That said, you should have no problem enrolling. They have the full range of physicians, hospitals, farmacias, etc among their practitioners.

Once you apply for and are granted "legal temporary residency" status, you will be required to enroll in the CAJA, the government's health care delivery system.

Thank you for the clarification on MediSmart.

I knew that most of their providers and services are in San Jose, connected with Hospital Metropolitano, but I think they have affiliates around the country and also are connected with the pharmacies at Walmarts, such as the two in Heredia.

I know that it is a discounted, pay-as-you-go program.

Travel insurance is not really an option for me, since I am over 70 with pre-existing conditions, and the coverage is either non-existent or exorbitantly priced.

That is why I am more inclined to enroll in something like MediSmart or one of its comparables in CR, such as Salud 360/Health 360.

From the research that I did stateside, I think MediSmart offers drug coverage, cancer coverage, vision and dental for a small, added monthly fee.

I don't want to have to pay out of pocket for my prescription meds, and am looking for the best-case scenario in which to enroll.

I appreciate the timely response of Dave & Marcia, and if anyone else can weigh in with similar advice, I welcome it.

--Geraldo

Regardless which of MediSmart's goods or services you avail yourself of, there will be an out-of-pocket cost. What I've seen online tells me that the greatest discount you can expect is 80% from one of the medical specialties. Everything else will be discounted at a lower rate.

There's no question that using MediSmart can save you money. The question is, how much? While MediSmart discounts everything, what's the "normal" or "typical" rate to which that discount is applied? If, for example, they show a normal rate that's twice what everyone else charges and then they apply a (say) 20% discount, that's no savings at all.

That said, our local general practitioner is a Medismart provider. Dunno the going rate for an office call, but via Medismart we pay c10,000. That is a deal!

Have you investigated travel insurance closely? My recollection is that at least some travel insurers will issue coverage without a lot of strings attached such as your age, state of health, etc.

Thank you again, Dave and Marsha.

I might have to utilize the "Pay-as-You-Go" method, but if I land the MediSmart coverage it would pay for itself with my prescription at the Walmart pharmacy in Heredia, about a fifteen-minute drive from where I am staying.

My landlord might take me there today, and I will check with the pharmacist to see whether I need a local doc to issue the scrip, and if not, what the actual out-of-pocket expense would be.

Yes, C10,000, or $20.00, is quite the deal for an office visit.

I appreciate that you took the time to flesh out your prior response.

All of the travel insurance to which I looked into counts my age (71) and prior conditions against me, and either will not issue coverage or does so with riders at an outrageous monthly rate.

I have concluded that I am better off self-funding, but would like to see if I can get extra coverage (even paying surcharges) with MediSmart for things like regular health care; cancer coverage; dental; and vision.

All hints and suggests are greatly appreciated.

Dave and M-A-R-C-I=A!

@gst1212

The people here almost never complain about the rain... somewhat refreshing.   

However, even after WEEKS of relentless downpours... some that can last 40+ hours; and include power outages and inundations of roads and frogs and snakes... I'll comment to one of the locals in my village about all the water... and they (usually the men) will say... "Yes, very good water!!" ...  while standing angle deep in mud.

They consider NO RAIN as bad...  so only the GOOD side, no matter "How Good!!!" it is... as being better.  😊

Thanks to the encouragement of DON & MARCIA in the comment stream above, I signed up for MediSmart today.

I investigated the website and reviews extensively.

CRIE recently gave it an unreserved plaudit.

I got long AI responses on ine, then encountered a person (Montserrat) in a chat, and finally called (no WhatsApp permitted) the office line and got George, an engaging English-speaking person, whom I found to be superb.

I am NOW officially enrolled in MediSmart.

I could have paid monthly (with the base fee of $14.50), along with the enrollment fee for the "virtual card" (@ $3.39, for the one-shot deal), but elected to do so over six months, to avoid fees with my card.

I signed up for the Premium plan, and it cost me $104.56 for this pay-as-you-go, discounted program.

No age limits or previous conditions.

I added $2.26/mo. for "Onco Smart Cancer Treatment."

They have some coverage for dental (Doctors Dent) and vision (Dr. Max).

I require a dermatologist's care, and two (2!) who participate in the plan are located in the neighboring provincial capital of Heredia.

One can use the online pharmacy (Farmacia LaBotica), but I prefer to go directly to FISCHEL HEREDIA (in Heredia, one of more than a half dozen in the province).

[FISCHEL is a national pharmacy chain with which MediSmart is associated, like CVS or Walgreens with DrugRx in the USA for prescription drugs, in an analogous way).

The also have a formal affiliation with CNS Salud Heredia (but not a smaller satellite clinic, CNS Salud Barva, with a concentration on nutrition, apparently."

I called the company number and supplied the necessary information: full name/DOB/address/passport number/phone number/email address.

George said it would be helpful eventually to get a local phone so that a "code" could be received, but right now, "I am good to go" and took a screenshot of my QR Code with the membership ID number and Company logo.

The process required some persistence and I was glad to have it under my belt.

Frankly, for the price point, the advantages strike me as terrific.

For a small add on, they feature discounted veterinary benefits for pets/mascotas that parallel one's own.

They also twin with many partners in dozens of business realms, such as food, travel, and entertainment.

It took me several hours, from start-to-finish, to wrap the process up, because I could not do so myself online, owing to a "frozen stream."

George should get an accolade in his personnel file. Top-drawer.

This program strikes me as "win-win" if you lack insurance in C.R. or want to supplement it with another option (either the CaJA or private travel insurance).

Considering that I am laying out $17.46/mo. for these benefits, I consider this "find" to be a huge net plus.

If you've not learned this already, whether you're using your MediSmart membership or paying full price, many, many pharmaceuticals are available over the counter in Costa Rica without a physician's prescription. Exceptions include strong pain management drugs, sleep aids, strong antibiotics, and probably some others, but many are available just for the asking.

If something has worked for you in the past, and you know the name (generic is best), strength and dosage, there's no reason to involve a physician.

The Fischel chain is linked to MediSmart.

They did not offer any discount, so on principle, I excluded them from my consideration, although one is located close to where I live.

A discount pharmacy chain actually charged less than Fischel quoted me (about $4.00 for a 30 tablet prescription, unfortunately not available generically). [= Farmavalue Costa Rica], located conveniently in my town].

MediSmart also has an ononline pharmacy that sells all kinds of OTC goods as well, such as sunscreen:

Farmacia LaBotica Express Services.

I could not order on the MediSmart website, since I do not have a Tico phone number (eight digits, separated).

I finally got through on a direct phone line and spoke to a PhD pharmacist, who took my order (he did not speak English, and my Spanish was good enough for him to gather the requisite information and process the order).

Much to my surprise, I received a motorcycle courier's delivery within four hours (from downtown San Jose to my small canton in a neighboring province, but within the delivery "Metropolitan area").

I received a 17% discount and the messenger got a $2.50 trip written into the receipt.

He was very pleasant, and I paid the courrier on the spot (one could use a credit or debit card).

The full month supply (30 tablets in two [2] separate boxes, or 60 tablets overall) cost me $132.21.

Delivery is free if the order is over $20.00 (with the small tip for the rider factored in).

Since I had no doctor's appointment to write the scrip (I traditionally paid this out-of-network on a discounted basis, out-of-pocket expense in the US), the adjusted amount [with no physician consulation) that a three-month supply would cost me is $263,.00, or about $2.92/pill.

The equivalent in the US for those without insurance for the brand name pill (in this case, Abbott Laboratories) would be $15.00/tablet  (my USA generic is manufactured in India; the Abbott brand in Latin America is manufactured in Brasil).

So, I now have stockpiled an extra "cushion" of a full month's supply without having to go out and get it from a local pharmacy, which is a convenience, though not an appreciable cost savings.

[I previously bought a 15-day supply of 30 tablets from the local Farmavalue.

I also attempted to make an appointment today with a dermatologist in a neighboring town.

She is English-speaking and MediSmart members receive a 60% discount, so the visit will cost me C27,000, or about $54.00.

That represents virtually the copay that I would be required to submit for a specialist on my insurance plan in the US.

MediSmart also offers basic coverage/benefits for vision (Dr. Max) and dental (Dr. Dent).

I made an appointment in the same town for the same day for a free vision examination, and "Dr. Max" offers a 20% discount to MediSmart users.

I had 20-20 vision three years ago when I last got progressive lenses and the frame in the US, but my eyesight has declined since, so I will take advantage of the opportunity and see what "Dr. Max" has to offer.

MediSmart has relationships with many specialists, institutions, and services around CR.

It's not a sure-fire solution to help those who cannot afford or qualify for medical insurance and have to pay-as-you go, but it certainly will help me to obtain quality medical services at reasonable prices.