| The INS Medical Regional is an alternative to Plan 16
and provides broader coverage. Who Can Be Insured? Residents
of Costa Rica ages 18 to 65 can apply. Sometimes people up
to 70 have been accepted. Once insured, INS will renew indefinitely
so long as the premium is paid. Dependents from birth up to
age 24 can also be insured.
What is Covered?
Medical expenses due to accident, sickness or maternity, up
to $200,000 per year. For people over 69, the coverage is
reduced to $60,000 per year. The policy will also pay for
an eye test and checkup, as of the second year. It covers
hospital care and ambulatory care. Subject to sub-limits,
also maternity, cancer, epidemic diseases, prosthesis, organ
transplants, ophthalmic care, air ambulance if treatment can
only be administered abroad, repatriation of remains, death
benefit for burial, etc. By means of surcharges you can increase
the cancer coverage, and coverage for severe medical conditions,
to $400,000.
Where?
Worldwide coverage. But the policy is designed for and works
best in Central America.
Main Exclusions
Conditions existing when the insurance is bought. Treatments
for obesity, cosmetic surgery, sterility, congenital conditions,
dental care, sex change, insemination, mental disease, addictions,
attempted suicide, self-inflicted lesions, pregnancy of dependents
except spouse, accidents when the insured was under the influence
of drugs or alcohol, correction of vision, for AIDS and HIV
positive, erectile dysfunction, chiropractic and podiatrist
care, tranquilizers, antidepressants, vitamins, non-prescribed
expenses, experimental treatments, accidents while practicing
high-risk or speed sports, medical expenses as a result of
cataclysmic events, terrorism, civil insurrection or war.
Pre-existing Conditions
Chronic conditions, at the discretion of INS, can be covered
if the applicant has had no symptoms in the last two years.
Claims and Deductible
In Central America there is a network of providers (doctors,
hospitals, labs, clinics and pharmacies), which includes Clínica
Biblica, Hospital CIMA, Clínica Católica and
others, where you will pay less because they are bound to
a price limitation imposed by INS, and you will get a lower
deductible. Also, for hospital care you use your insurance
card to cover the balance. With preferred providers, for hospital
care you pay for one day of hospital room, plus 10 percent
of the following $5,000; for ambulatory care you pay $10 per
doctors'visit, plus 10 percent of other prescribed expenses.
With outside providers, for hospital care you will pay for
one day of hospital room with a minimum of $200, plus 20 percent
of the next $20,000; for ambulatory care, you pay $20 per
doctor's visit, plus 20 percent of other prescribed expenses.
How Much Does It Cost?
You can choose from three levels of insurance. Premiums depend
on the level, and on age and sex of applicants (costs shown
in U.S. dollars). Some averages of yearly premiums:
Adults
Age
0-18 ............................... US$ 448 .................................
US$ 524
19-25 .....................................470 .........................................
562
26-29 .....................................498 .........................................
602
30-34 .....................................553 .........................................
678
35-39 .....................................640 .........................................
783
40-44 .....................................692 ........................................
865
45-49 .....................................829 .........................................
931
50-54 .....................................953 ......................................
1,086
55-59 ..................................1,068 ......................................
1,179
60-64 .................................1,348 .....................................
1,364
65-69 .................................1,625 .....................................
1,599
70-75 .................................2,090 .....................................
2,046
Children to 10 years.
Both genders
1 kid............................... US$ 226
2 kids .....................................291
3 kids + ................................. 376
Applications
No medical examination is normally necessary. For bureaucratic
reasons, policy applications are best filled out by an agent.
You must pay the first premium at the time of applying. The
policy comes into effect 30 days later. Some medical conditions
have a 10-month moratorium.
What numbers do I phone for medical assistance when
I am away from Costa Rica ?
- Within the United States: 1-866-543-6307 (toll free)
- Any other country except Costa Rica: +1 (305) 463 9635 (you may call collect)
Disclaimer: This document is intended as a summary of most relevant points of
the insurance policy; as such, it does not contain every provision
stated therein.
Courtesy 2005 Garrett & Associates, http://www.segurosgarrett.com
INS Medical International
Who Can Be Insured?
Residents of Costa Rica ages 18 to 65 can apply. Applications from people up
to 70 have sometimes been accepted. INS will renew indefinitely
so long as the premium is paid. Dependents from birth to age
24 can also be insured.
What Is Covered?
Medical expenses resulting from accident, sickness or maternity, up to $2 million
per year. For people over 69, coverage is reduced to $600,000
per year. The policy will also pay for a yearly eye test and
checkup, as of the second year. Covers hospital and ambulatory
care. Subject to sub-limits, maternity, cancer, epidemic diseases,
prosthesis, transplants, ophthalmic care, air ambulance if
medically required, repatriation of remains, death benefit
for burial, etc.
Where?
Worldwide coverage.
Main Exclusions
Conditions existing when the insurance is bought. Treatments for obesity, cosmetic
surgery, sterility, congenital conditions, dental care, sex
change, insemination, mental disease, addictions, attempted
suicide, self-inflicted lesions, pregnancy of dependents except
spouse, accidents when the insured was under the influence
of drugs or alcohol, correction of vision, treatment for AIDS
and HIV positive, erectile dysfunction, chiropractic and podiatrist
care, tranquilizers, antidepressants, vitamins, non-prescribed
expenses, experimental treatments, accidents while practicing
high-risk or speed sports, medical expenses as a result of
cataclysmic events, terrorism, civil insurrection or war.
Pre-existing Conditions
At the discretion of INS, these can be covered if the applicant has had no symptoms
in the two years before an application is submitted. Claims
and Deductible
In Central and North America there is a network of providers (doctors, hospitals,
labs, clinics and pharmacies) where you will pay less because
they are bound to a price list imposed by INS and you
will get a lower deductible. Also, you use your insurance
card to cover the balance for hospital care. (You can also
get this insurance with a blanket, per-year deductible, where
you accumulate your medical expenses and, if in the policy
year they exceed the limit, you can claim for the excess.)
With preferred providers, for hospital care you pay for one
day of hospital room, plus 10 percent of the following $5,000;
for ambulatory care you pay $10 per doctor's visit, plus 10
percent of other prescribed expenses. With outside providers,
for hospital care you will pay for one day of hospital room
with a minimum of $200, plus 20 percent of the next $20,000;
for ambulatory care, you will pay $20 per doctor's visit,
plus 20 percent of other prescribed expenses.
How Much Does It Cost?
You can choose from three levels of insurance. Premiums depend on the level,
and on age and sex of applicants (costs shown in US dollars).
Applications No medical examination is normally necessary.
For bureaucratic reasons, policy applications are best filled
out by an agent. You must pay the first premium at the time
of applying. The policy comes into effect 30 days later. Some
medical conditions have a 10-month moratorium.
What numbers do I phone for medical assistance when
I am away from Costa Rica ?
- Within the United States: 1-866-543-6307 (toll-free)
- Any other country except Costa Rica: +1 (305) 463 9635 (you may call collect)
Courtesy of 2005 Garrett & Associates http://www.segurosgarrett.com
|
