Is Costa Rica Medical Care really free?

Costa Rica has some of the BEST medical care in the world. One of the biggest businesses here is what is called Medical tourism. The quality is so good, and so advanced that people fly from all over the world for everything from cosmetic surgeries, to hip and knee replacements, Lasik eye, and dental work. And it is a fraction of the costs compared to countries like the USA; generally about 15% of what you would pay back home. Many of the Doctors did their residencies in the USA and the nurses and staff is some of the friendliest and nicest people you have ever met. Thousands of people come here every year for procedures.

Costa Rica has Socialized medicine, like many countries in the world, and for all citizens it is “free.” But as we all know, nothing is really free; it has to be paid for somewhere. In Canada, you pay for it with massive taxes, some of the highest in the world. So you might not physically send a check every month to Blue Cross Blue Shield, but trust me, you are paying for it every paycheck in your income tax. Costa Rica medical care is very similar. The system is called CAJA, which represents all the services that are given to the people; medical, Social Security, disability. Every month, the employers send a percentage of the employee’s salary into the system which goes to fund these services. Self Employed people have to claim a salary in the corporation and base their CAJA payment on that amount.

If you move to Costa Rica, you are probably not going to be working for a company and if you are then they will withhold some of your check to make sure you have access to CAJA. You will either be an investor, who is living off of their assets; a retiree living off of their pension; or a self-employed Entrepreneur running a business of some kind. This is also how you will obtain your residency. With all 3 of these an income level will be established and you will have to pay into the system to obtain the CAJA and the “free” medical care. For most foreigners it is somewhere between $50 and $200 per month. In the scheme of life, this is a very small fee. Costa Rica wants foreigners to move here, retire, invest or start a business. But they cannot afford to just have thousands of gringos show up and start taking from their system without contributing something back. The last thing they want is a bunch of old, sick people, moving here, and using up their FREE medical services and milking the system. They want people who are investing and contributing to the system, and they will welcome you with open arms. What a concept huh? And if you want or need good medical care, this is a very small price to pay to be allowed into the CAJA. Thousands of Ex Pats are enjoying and using this every single day.

I am a permanent resident of Costa Rica and pay a monthly payment into the CAJA. I don’t look at it as paying for the medical; I look at it as a small fee to be able to live in paradise. If you told me 20 years ago I could live in the most beautiful place in the world for less than 2k a year “fee” SIGN ME UP. Although I am in the CAJA system and have access to the care, I probably will never use it, as I also have private medical insurance, as do many of my clients. Obviously if you can afford to purchase private medical insurance you will, as it gives you access to more services without having to wait. Like anything that is free, you usually have to stand in line and might have to wait for certain services. With private insurance, just like back home, I can pick the Doctor, pick the hospital, and set up an appointment. Most of the private insurance carriers here are under the Lloyds of London Umbrella, and it covers you ANYWHERE in the world. I have a phenomenal policy, with only a $2000 deductible and I pay less than $300 per month. Similar coverage in the USA is over $12000 PER YEAR. The catch though, is that I MUST live outside of the USA; easy for me as I have no desire to EVER GO BACK.

One of the main reasons so many people choose to live here is because of the phenomenal Costa Rica medical care. And with 3 hospitals here in the Liberia area, most foreigners choose this location for living. Other than San Jose, there are really not many options for great medical care, as most of the country is very rural and underdeveloped. And the majority of people moving here want to live at the beach, not in some crowded city with buses, taxis, traffic and smog. Here we have some of the best hospitals in the world. There is the CIMA hospital just 7 minutes from the beach.

I had back surgery at CIMA so I can attest to you about the quality of the care.

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There is the San Rafael El Arcangel Hospital in downtown Liberia. If it wasn’t for this hospital I might not be alive.

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There is also a wonderful Public Hospital in Liberia as well.

Playas del Coco in Guanacaste is the only community outside of San Jose that has a 24 hour EMERGENCY CLINIC, equipped with a state of the art Ambulance and a trained EMT. We have dozens of defibrillators now, located all over the community, and many local clinics as well for minor cuts and bruises. We also have one of the best Dental offices in the country. Truthfully, if you care about your medical services, and you should, there is only one country to move to, Costa Rica, and only one community to live in; THE BEACHES OF THE PAPAGAYO.

Hopefully, you will never need the Costa Rica medical care, but if you do; rest assured you will be in good hands.

Michael Simons

COME ON DOWN BABY!

Are there Costa Rica Property Appraisals ?

Technically, there are appraisers in Costa Rica, but the reality is that they have no idea what they are doing, especially at the beach. Because there are very few mortgages given on Costa Rica property, and almost NONE to foreigners, there has never really been a need for an appraiser. The few that exist are mostly for farm land, where they comp everything on a square meter price, based on the last farm that sold. A Square meter price doesn’t apply when you are dealing with the type of land we are, as the lots vary drastically from development to development. For instance, a ¼ acre lot down a dirt road, and not in a gated community, is worth substantially less than one that is located on a golf course. And a lot with a gorgeous volcano view, although the same size, has a higher value than one that doesn’t. Put that lot on top of a mountain, looking at the ocean, inside a beautiful community and it has a tremendous more upside. Also many lots are located on a hill, where 75% of the total land size might be down the side of a cliff. So what is important is the size of the building pad, and the quality of the view, not necessarily the overall size of the lot. I have seen ¼ acre lots sell for 5 times what an acre lot sold for because the smaller lot had the “million dollar view.”

When it comes to houses it can be even more difficult to properly appraise it, as homes are built with many different finishes, nice bathrooms, fixtures, kitchens, furniture, pools and construction quality compared to others. And a newer home usually has more value than an older home as there might be maintenance issues that need to be addressed. On top of it, there is no formal MLS as I have mentioned in other blogs. So you cannot just click in an address and see what the house sold for down the street. And even if you knew, the homes are all completely different, each one unique and special. It is not like the USA where you have track home builders who cookie cut the same home over and over. Also, in certain areas of Costa Rica, property has a much higher value because the infrastructure is better, there are more amenities in the town, you are closer to the airport and hospitals, and there is more demand from buyers, as the market is hotter in those places. A 3000 square foot house in Laguna Beach California is worth 10 times what that same size house is worth in Bakersfield or Riverside and maybe 30 times what it is in Idaho or Kansas.

So how do you know you are getting a good deal when you are shopping for your little piece of paradise? Good question. This is why it is imperative that you work with a professional full time real estate agent. Make sure the agent is a legal resident of Costa Rica and a licensed agent with CRGAR (Costa Rica Guanacaste Association of Realtors.)  Ask for referrals and references, as we know the market better than anyone. Personally, I can tell you about almost every single Costa Rica property in the area. Who built it, when it was built, how long it was on the market, who owned it, what it has sold for and if there were ever any issues that might be hidden now.

Since there are no appraisers, we as agents get asked to do this when it is needed; for Self Directed IRAs, income tax filings, family trusts etc and unfortunately when there are deaths and divorces. So how am I able to comp a property then, you ask? Here is how.

If it is a condo, where there are others exactly or very similar it is easy. We know the market; we know what has sold and what is on the market now, so we can compare it too similar units with similar finishings and furniture.

Same thing with a piece of dirt or a lot. We can see what another lot, with the same view and location has sold for, and informs you if the property you are looking at is priced correctly.

Houses are a little more complicated and this is where we really come in to play. I tell my clients all the time, that the way to know if you are getting a good deal on a house is to figure out the replacement value. We determine what the price of the lot would be. We have a very good feel for what new construction costs, as we are involved in many construction projects in the area. So if you can buy a house that is finished, for less than a new one then you are getting a good deal. We have to factor in what repairs need to be made, and if new furniture or appliances need to be purchased. And we can find out if there are any maintenance issues with a good inspection by a reputable contractor.

If it is a brand new spec house, then most buyers are willing to pay the same price or even a little more, as it saves them the 12-18 months it takes to design and construct a home to completion. If a brand new house is complete and being sold for 350k most people will buy it, over building it to save $15-20k. You can start enjoying your second home right away, and many times make that in rental income in the time the house would have taken to be built. Remember though, the most important point is that you get the house that YOU WANT. This is your dream home, your Pura Vida, your little piece of paradise. You have worked your entire life to finally get to this point. Don’t lose it over a couple of dollars. Don’t buy one Costa Rica property over the other just because it might be a little better deal. In the end, negotiate the best price you can for the home you want, and then buy it and start living your life. It is too short already.

Trust me, after a year of sitting in your pool, relaxing and drinking a cocktail, you won’t care any more about those couple extra bucks.

COME ON DOWN BABY!