“INS MEDICAL” REGIONAL POLICY

This is an extract. Please read the entire policy to get the full picture. Following are the coverages available. Within certain rules, you can select the coverages you need and pay for the ones you get.

Extract

WHO CAN BE INSURED

Residents of Costa Rica ages 18 to 65 can apply.  Sometimes persons up to 70 have been accepted. Once insured, INS will renew indefinitely so long as 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 persons 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. 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 disfunction, chiropractic and podiatrists’ 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 DEDUCTIBLES

 In Central America there is a network of providers (doctors, hospitals, labs, clinics and pharmacies), which  includes Clínica Biblica, CIMA, 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% of the following $5,000; for ambulatory care you pay $10 per doctors’ visit, plus 10% 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% of the next $20,000; for ambulatory care, you will pay $20 per doctors’ visit, plus 20% of other prescribed expenses.

HOW MUCH DOES IT COST?  

Examples of typical yearly premiums.

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. Policy comes into effect 30 days later. Some  medical conditions have a 10 month moratorium.  

 4/06