Tag: medical

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Doctor Visits

CARDIOLOGIST
Monday I had my first follow-up visit with my CAJA (government healthcare program) at Alajuela Hospital where my cardiologist did another EKG and a ultrasound of my heart. Then he personally monitored a treadmill test of my heart followed by another ultrasound he monitored. It was amazing to me that I was in and out of there in 45 minutes. He told me that the only other test he would like to have on me is an angiogram which he could not order until he consulted at least one other cardiologist there in the Alajuela Hospital because there is not much indication that I would have any blockage. He said he would call if it was approved and then I would have to go to Hospital Mexico in San Jose, which is the only one with the equipment to do an angiogram. It is the primary or main hospital for Costa Rica CAJA or government healthcare.

Well, his technician called me today y hablando sólo en Español. We both struggled through but basically I have to go back anytime tomorrow and get some “documentation” or paperwork from them in Alajuela to take to Hospital Mexico for an appointment for the angiogram. If I understood her correctly, my Mexico appointment is April 10 at 10 AM, but not clear yet if that is when I get the angiogram or, if like most things here, I may just be making an appointment for one much later. I should find out tomorrow.

This is how “single payer” or government or what Americans like to call “socialized medicine” works with priorities given to more serious things, emergencies, etc. It took two months for my first appointment with my cardiologist. No problem for me to wait for this as I don’t believe I have a serious problem. Best of all: No more cost for me now that I have a CAJA card, even if it led to the unlikely case of heart surgery.  I will keep you posted. Dr. Hernandez is basically building a file on me and my heart for any future needs and trying to be responsible for my heart. I appreciate that!

DENTIST
Today I visited my dentist who also speaks only Español and we managed fine for my annual teeth cleaning and checkup by the dentist herself and not a technician. She says once a year is fine and not the every 6 months U.S. dentists request to increase their income. She found the need for one tiny filling which I’m scheduled to get next Tuesday. And that is it for a year! And cheap! Many Americans come here for dental work to save thousands of dollars in what is sometimes called “medical tourism” or even “dental tourism.” A friend in Tennessee has come here twice for his dental work and saved a lot more than his plane ticket and hotel bill. That is for big work like bridges and caps.

Someday I will think about taking a photo at one of these places! It just hasn’t been on my mind with everything else to do like getting there and communicating!  🙂

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My first free prescription!

Waiting in line for my “free” prescription
at the local government Clinica Farmacia.
The right line is to give them the prescription & left to pick it up.
Depending on work load, 1 to 3 hours wait. I just left and returned later.

My local private doctor diagnosed me with heart arrhythmia and through an expensive private cardiologist in San Jose I was given an expensive beta blocker at about 60-80 bucks a month. My local private primary care doc found a generic version at about half that price, but I talked to my government primary care doctor anyway. As reported earlier, he sent me to a cardiologist at the Alajuela Hospital where I would go with emergency heart problems on the government plan. And the really nice, 30-something cardiologist checked me out and said he could give be a prescription at no cost but it would be different from what the private doctor gave me (a 3rd brand of beta blocker). It is Atenolol and after researching it online I discovered that it is the most used med for arrhythmia in the U.S. or all around the world right now. So I am just now experiencing one of my big savings through CAJA, the government health plan.

As I think I explained earlier, I am keeping my foot in both doors “just in case” because some hospitalizations, surgeries, or other procedures have long waits in the government program unless an emergency. i.e. Hospital Alajuela will be my government hospital where I have a cardiologist already. Next Monday I have a consultation at Hospital Metropolitano San Jose which will be my private hospital of choice when the public hospital is not available. I joined a discount program with them and will save up to 80% off many services there compared to other private hospitals. At my age, regular private insurance is just too expensive, so this is my self-made plan and I plan to use the public services as much as possible as in this case with heart medication, but if needed, I have a private option that I hopefully can afford. 
When you are an immigrant in another country, it takes time to get all the details worked out. But it feels good when you do!  🙂

And after stirring up people on Facebook with a comment about Trump, I’m going to stay focused on BEING an immigrant and not telling people how to solve the immigrant problems in the states!  🙂

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My almost wasted Friday!

It was the first week of July when the CAJA set up my next appointment with my assigned doctor who was not there then for my initial physical. They scheduled it for September 12 with lab work on September 2 and for me to go to Alajuela for a EKG in that larger clinic, which I put off.

I had two different prescriptions for these two free testings, but filed them away and forgot about them. Last week I went to the clinic in Alajuela and told them I was supposed to get an EKG. They can’t do it without a prescription from a CAJA doctor. Well, I’ll tell Doc on the 12th, figuring I didn’t have one.

This morning at 7 was my appointment at the clinic lab for my blood work. I’m there by 6:30 (walking) and wait an hour to get to front of line where they tell me they can’t do it without a prescription. I walk back home and dig through my CAJA folder and sure enough, there it is AND the prescription for the EKG! I’ve become a FORGETFUL OLD MAN! Tired and sweaty by now after the two mile round trip walk, I call a taxi and take both prescription (I’m going to Alajuela after the lab and finish this stuff today!)

I’m back at lab by 8 and with my blood given and out by 8:30. Walk to bus station and in Alajuela’s Clinica Marcea Rodriquez with my prescription for a EKG by 10:00. I’ve about got this testing licked I thought! I’m escorted to the cardiology waiting room of musical chairs where I’m only 3rd in line. Good prescription they tell me but you must have a cita, an appointment! So after several minutes on her computer she tells me my appointment is 26 December at 11! My helper who walked me over there said, “Oh! You’re lucky! It’s this year!”  🙂   Well, I have an earlier EKG from a private doctor, so I’m not worried and it is no skin off my new doc’s back! Go with the flow and learn the system!

Part of the Pura Vida spirit of Costa Rica is having a “What? Me worry?” attitude. All of this kind of stuff is seen by so many people here as God’s will and you just take it as it comes! But it would have helped a whole lot if I had remembered that I had prescriptions and where I put them!

I ate lunch at Taco Bell in Alajuela (we have no fast food in Atenas) and bus had me home by 1:00 – very tired! 

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After Much Effort – I’m Insured Again

My Carné card is what will get me all needed medical service;
including prescriptions, doctor visits, hospital, surgery, tests, etc.
at no extra cost to me above the $114 a month coverage fee based
on my U.S. Social Security income check deposited in a bank here. 
The instructions said bring the original of each needed document and
one copy. In my usual overkill I made 3 copies of all and took it with me.
He didn’t even want one copy beyond the originals, BUT . . .
He did not like the digital printed receipt of my electric bill and made be go for a
traditional paper bill mailed to houses with no email. Very difficult to get!
But with help of my amigo Jason Quesada & landlord, we finally got it in time.

I still have to go back to Immigration 28 July for my Cedula or residential ID card, but I am legally a resident now with full medical coverage. An American Tico? Well, more secure anyway! 🙂  

Next week I will schedule my initial appointment with the Caja doctor assigned to me, getting a physical and giving him my medical history. It will be interesting to see what they do with my Sleep Apnea and the recently discovered heart arrhythmia. For some specialists I may have to go to Alajuela or San Jose, just like with the more expensive private doctors. 

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Getting Reimbursed for Medical Expenses

The private medical services insurance here is mostly through a government program called INS, a Spanish language acrostic. I finally completed the piles of paperwork with doctor signatures and original receipts (No photo copies! One of my claims was disqualified for this reason.) I mailed them to my insurance agent who got them to INS and I received an email pretty quickly telling me what was accepted and how much they would pay me with an electronic deposit in my local bank account when they received the account number. (I added to the time here by at first sending the wrong number dummy me!) When I finally got that right they informed me that since I still don’t have official residency yet, they could not auto deposit but I could come to an INS office or my agent. My agent requires 15 days, so I opted to go to INS somewhere close other than in San Jose. Alajuela is the closest and I went today and even with one problem, I completed the task within two hours! That is could! The problem was that my agent gave me the wrong address or directions to the office in Alajuela and I wasted one taxi fare ($2) in the wrong place. When I got to the right office, a typical government office with guards and take a number and wait until they call it to be served. It was surprisingly quick with only three employees needed to complete my task and they paid me in cash!

That is likely the last/only time I will do that since I canceled my expensive policy. I’m waiting to receive the government coverage after my residency is approved. Hoping that will start happening this Friday the 13th when my attorney appeals! Ironic? Probably! But I’m not superstitious!

And by the way, this experience today continues to strengthen the motivation to learn to speak AND understand Spanish. It is necessary to live here! 

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In the Shadows

My shadow on neighborhood walk.

And I feel like I’m still in the shadows of the U.S. Government and U.S. Big Business! It was very easy to cancel my MediGap Medicare supplemental insurance with Mutual of Omaha. I applaud them for their courtesy, understanding, and simplicity in dropping an unnecessary and unusable insurance plan. 

But the much less expensive or helpful Medicare Rx Plan with Cigna HealthSpring who was not helpful when I was in the states and now that I live in another country and cannot use their plan, they have been less than helpful in what they call “Disenrollment.” Three overseas phone calls since March, promises of sending me a Disenrollment Form, and still I am being charged monthly for a Rx insurance I cannot use. Grrrrrr! After today’s call I wrote a letter I will fax tomorrow that is suppose to do the same thing as the form. (?) Plus they promised again to send me the form to my U.S. address as backup plan 2, and plan 3 (that makes me shudder) is I am going to call the U.S. Medicare office tomorrow. Cigna-HealthSpring will also let the government request disenrollment. I dread another overseas call which costs enough I will need to add more time to my cell phone sim card. And I’m always surprised when a government office actually provides some help. But maybe! The embassy here has, especially with Social Security and voter registration.

Why am I canceling U.S. medical insurance? (Not Medicare) (1) None of it works while living here (not even Medicare),  (2) It is very expensive, and (3) I have private medical insurance here I will continue until my residency is fully processed and I can be on the government medical insurance plan here when I will really save money. The private plan here is less expensive than stateside insurance and similar coverage. Plus medical costs here are so much less expensive that I could come out ahead paying for it with no insurance if nothing big happened! But then, potential catastrophes are why we have insurance in the first place. 🙂  And I’m keeping U.S. Medicare for that reason, just in case I travel to the states and something happens there, I will at least have basic Medicare coverage. And it is more involved to cancel or drop it and I think the hundred something I pay a month for it is worth it for now. Maybe not later. We’ll see.
I also have a sweet deal with my primary care doctor here so that I can come in anytime I need care or just have a question. i.e. I’m going to go by this week or soon and ask for her opinion of the many dentists in town and schedule my first cleaning and checkup. Cheap! Medical tourism is big here, especially for dental work! The cost is a small fraction of the U.S. costs. 
Today my new maid cleaned the house while I went to Alajuela to pick up three internet orders. I prefer to be out of the house when she is cleaning.  I did two little posts on my new Spanish Learning Blog today.  Pura Vida!

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Nickel Bananas and Other Expenses!

White-faced Capuchin Monkey, Rescate Animal zooave (photo gallery)

Though I am saving receipts and trying to live simple, I am not keeping a penny by penny account of what it is costing me like the couple up the mountain from me are doing in San Ramon. Read their blog and/or subscribe to it at Retire for Less in Costa Rica. I enjoy reading their monthly posts and admire them for the exact accounting of what they are spending in their public monthly financial report. To read one month’s costs use this link to their September Expenses or at their site find any other month.

I subscribe to their philosophy, though I’m not budgeting as detailed as they are nor keeping such records now. Simple lifestyle and enjoy the place! My expenses are similar to theirs with me spending less than a fourth of their TRANSPORTATION cost since I do not have a car like them. They spend $500 to a $1,000 on a car monthly while I spend less than $100 on bus and taxi transportation right now. Plus I walk 3 to 5 miles a day for local needs. When I start traveling across the country exploring, it will go up but seldom over $100. I can take a bus all the way to Panama or Nicaragua for around $50. So far the most expensive bus has been to San Jose at about a $1.75 while local taxis are seldom over $2 for door-to-door service. Though a taxi all the way to San Jose or Alajuela can be $25! It would still take a lot to of personal driver trips to reach their $900 budget! And I think Atenas is a more central location for my later exploring the country! (Plus better weather!)   🙂  And oh yes! Very important! Once I have my Pensionado Residencia card as a retiree, all bus trips will be free! For over age 65.

HOUSING expenses for me are right at the same as the Retire for Less couple and it is of course my largest expense at $800 per month plus my first month’s electric bill was $22 which is less than the $30 I was told to expect. But by March I plan to work with the new management on a long-term contract for rental at less than the current rate. We will see how that goes. Water, TV, internet are included in the rent here. I only pay for electricity and fortunately I seldom use the air conditioner. And oh yes, for those in Nashville comparing, that is much less than half my rent at McKendree which was increasing each year. Now note that I have looked at two houses for about $400 a month rent plus utilities, BUT . . . old town houses nearly touching the neighbors, not as nice, or quiet, or large property, and no view! I’m doing all I can to stay where I am as much for the view as anything. Plus monkeys will start coming in March or April! 🙂

Yet I spend more than the Retire for Less couple on DINING OUT which is a priority for me – my one extravagance maybe. I eat out 5 or 6 times a week with each meal ranging from USD $5 to $14 as the most expensive so far. The high end is when I add fruit drinks or smoothies and/or desserts – again that is my extravagance. When I eat out it is usually for lunch (done dinner three times with friends), sometimes a late lunch and always as my main meal. That is where I get most of my meat or fish and most veggies, though some at home. Dining out will probably be around $300 per month which is almost what I spent in Nashville in addition to the $240 dining room charge at McKendree. So I’m spending less dining out here than in Nashville.

GROCERIES for me are close to what the Retire for Less couple spend in their budget, $300+ per month for breakfast and dinner food and household items like paper goods, cleaning supplies, kitchen tools at first. That is close to what I spent in Nashville. My usual breakfast at home is similar to then except more fresh fruit. I have a half bowl of healthy, whole grain cereal with nuts and raisins to which I add a half bowl of fresh fruits and then either cow milk or almond milk which is priced a little more than in the states. Cereal is all more expensive here (even Latin American brands) as are any brand-name food items. i.e. 300 grams of American branded tortilla chips is $4 while a similar Costa Rican product is $2 for 320 grams. Same for a jar of salsa. I’m learning to look for local products! Import tax is the primary income for the government here  making all imports more expensive. My groceries come from three places: I shop at the Weekly Farmers’ Market, plus Coopeatenas Super Mercado (a local cooperative), and sometimes Maxi Pali, a corporate super market chain by Walmart with their house brand products and claim of being cheaper. It is a longer walk, so I use Coopeatenas more. And once a month or so I may go to the real Walmart store in Alajuela and maybe someday will go to a bigger one in Escazu, though more time, trouble and expense to get there. And oh yes! Bananas were a nickel apiece at Farmers’ Market yesterday.

HOUSEHOLD PRODUCTS are priced about the same as the states if I go for the Chinese brands, like a cheap wastebasket, laundry basket, kitchen utensil, hardware, etc. Again USA-made are more expensive and not as available. My house is about set up now, so I will seldom have these expenses. My new Atenas “Home Depot” is a neat little hardware/household store by the bus terminal where I’ve found things not even at Walmart. They are friendly and helpful even though I struggle for Spanish words for things. I even got a USB extender cable for the used printer I bought, so the shorter cable would not run across my desk and block access to the window. Show you my office later.

ENTERTAINMENT/TRAVEL expenses have hardly started yet as I get acquainted with Atenas and haven’t traveled further than San Jose and Alajuela which is budgeted in transportation above. My only typical tourist expense was my trip to see Rescate Animal zooave (click for my photo gallery) last week and without my residential card yet I had to pay the tourist rate of $21 to get in which would have been about $10 as a resident and maybe cheaper as a retiree. The bus trip was just a dollar there but when I had trouble flagging the bus down for my return, I spent $20 to return by taxi. All that plus lunch cost me less than $50 for a fairly local photo trip. I could spend hundreds when I start going to the beach, mountain lodges, etc. Just haven’t started yet which is good because of start-up costs. I hope to eventually be spending $300 per month on travel, my favorite entertainment. There are big movie theaters, live theater, symphony orchestra and all in San Jose, but I will be avoiding the big city as much as possible! I’m liking small town life better! I want to visit national parks, wildlife preserves, and other places for nature photos. It will take years to see them all!

A MAID has not been hired yet, but that will cost me $2 per hour for two hours once a week or about $16 per month plus a Christmas bonus of one month pay (required by law) making it $208 per year. Such a good deal that I need to get started soon! If I want to add laundry, cooking or other duties then the cost would go beyond two hours a week, but I probably will not. I’ve already got a laundry routine and getting use to sunshine clothes drying. And a single person doesn’t need a cook!

MOVE/START-UP EXPENSES have not been totaled yet, but shipping 51 boxes will end up costing me over $2,000, maybe $3,000, the biggest expense. Of course that is nothing like the people sending all their furniture in 40 foot containers. And I hope to get rid of half that stuff after I go through it here, mostly scrapbooks and artwork.

Once all the different fees and lawyer is paid, a residential card will cost nearly $2,000.

My Miami address costs according to what is sent through it, at $7 per kilo on packages plus customs/import tax on the invoiced value of the item (10-15%). Letters cost me $1.50 each when sent through Miami. They get here a little quicker than the two to six weeks when sent direct, but I am going to start encouraging people to use my Costa Rica address. I got several Christmas Cards I had to pay $1.50 each for AND had to travel to Alajuela to pick them up. I’m probably going to reserve the Miami address for internet orders, some of which require a USA address. That is what most people here use it for, including locals. It is an ongoing cost of maybe $40 to $50 per month, if I order much on internet. Two of my credit cards use that address and some other businesses, but most seem to prefer my Atenas address. The U.S. Postal Service would only accept the Costa Rica address and will not forward. But I’m glad now because if they had the Miami address they would be forwarding junk mail to me at $1.50 each! And I may try to get my own PO Box when I know I’m settling here. Right now it goes to the apartment’s box and the staff deliver to me on their time.

Local medical costs could be considered in start-up costs but I will list it separately. Even with that my total initial move cost is maybe $7,000 and I made more than that on the stuff I sold in Nashville including my car. So the balance sheet is okay for now.

MEDICAL costs will eventually cost me much less here once I am an official resident. I arrived sick with something like bronchitis. A visit to an English-speaking doctor, “Dr. Candy,” and her four  prescription meds cost me about $100 cash ($50 for her). I can try to turn it in to my Medigap insurance but it may not be worth the trouble. Medigap is good for the first 90 days here. I am applying for a private insurance policy here in Costa Rica with my physical scheduled for Tuesday morning in San Jose. It will pay 90% of all medical costs after the first $300. I will carry it for at least a year or until my residency is official. Then I can choose to keep it or go on public medical care which for about $50 a month will be 100% coverage of all medical costs including Rx, surgeries, hospital, dental, eye care, etc.(Why can’t Medicare do that?) Just longer waits for some procedures. That is my plan. Then I may drop the private plan here and will probably drop my medigap plan in states sooner. Private insurance here will cost about $3,000 a year ($250 month) which is less than half what I pay for medical coverage in the states (Medicare+Medigap+Rx+dental insurance) with fewer restrictions here. Public healthcare will be even more of a savings here. If I go back to states for any reason, temporary or permanent, I will still be on Medicare – they will keep deducting it from my SS check and I am always covered when physically in the USA, but never outside the states. I cannot drop it. So it will become my medical insurance in the states and funny thing is, the private insurance here in Costa Rica will also cover me when I’m visiting in the states!

Bottom line, I am now living on about $2,500 a month that could get to $3,000 with enough good trips! 🙂 That is less than I was living on in the states. Simple living, simple pleasures!

Well, that is a lot, but I know that a few of you have wondered about the costs and if you are considering such a move, can you afford it? Well, I hope this helps those considering and friends who just wonder but too polite to ask. Most of you know that I don’t have secrets – and/or I talk too much!  (TMI one friend will say!) But that is me and my financial report for life in Costa Rica. I don’t plan to post monthly reports like my friends in San Ramon, but for such details, subscribe to their Retire for Less in Costa Rica Newsletter.

Sorry this was so long! But that is all I’ll say on money!

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Why I Hope to Die at 75 . . .

Got your attention, huh? That is the title of a philosophy (not a book yet) that was reviewed tonight on the PBS Newshour, Why I Hope to Die at 75 by Dr. Ezekiel J. Emanuel. The link is to The Atlantic interview since I can’t find Judy Woodruff’s interview on PBS.org.

What the doctor brother of Ron Emanuel is talking about is something I basically subscribe to, though I expect to live past 75 which happens for me next year in Costa Rica! Otherwise, let nature take its course! One of the things he says is:

Once I have lived to 75, my approach to my health care will completely change. I won’t actively end my life. But I won’t try to prolong it, either.

That has become my philosophy after two years living in a retirement center that promised an active lifestyle but has at times depressed me with the mostly infirm residents talking more about their ailments than anything else while I trip over walkers and wheel chairs in the dining room, my first nudge toward retiring in a place like Costa Rica. I actually expect to live to 85 or 95, but I could just as easily go next year and I’m ready if so. When I cease contributing to my world and start being a drain on the world and the people around me, then it seems best to go. Though basically healthy now, my body is not getting stronger, healthier or better. I am past “my peak” and will at some point become a drain on society and that is what I do not want. Well, read the article and you will see what I mean.

In the meantime I’ll do the things I enjoy the most: interacting with nature, loving God and people, and find a church or Christian fellowship. I believe I can do it with more freshness and adventure in a tropical rainforest! (I’m weary of everything American.) The move is already helping me simplify my life and slow down – just one adventure a week!  🙂  I think I will rest more, write more, create more photographic images. Of course having no grandchildren also makes it easier to go.

After I gain residency, I will get on the very affordable government healthcare program, CAJA, that will not likely try to over-extend my life and my advance directives are already in place. No more colonoscopies or worrying about my health, cancer, heart or stroke. When it is time to go, I will hopefully go quickly. Plus I have insurance that will fly my ashes back to Nashville to be buried next to Juli (If I haven’t donated my body to C.R. Medical School as I had planned for Vanderbilt in Nashville). Either way, a perfect ending.

In short, Dr. Emanuel’s philosophy seems to fit in with some of my unstated reasons for moving to Costa Rica. I’m nearing the end of my life and choosing to end it in a place I truly love. Simple.

And friend Robbie shared another quote that fits my big move:

Taking a chance and stepping beyond the safety of the world we’ve always known is the only way to grow.”
— Wil Wheaton,
American actor
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Major accomplishments this week for Pura Vida!

A branch of the Savegre River, Costa Rica, 9/2014
Photo by Charlie Doggett – Click photo to View

Pura Vida!
Here’s a summary of things I’m working on now for the move and at least one sorta funny story in it. This could especially be helpful to those of you considering a move as you see what I actually did on some of the steps I outlined earlier. Pura Vida explained at end of this post.

FIRST, THE CORRECT APARTMENT LINK
The email version of last night’s post had the wrong link for the apartment I’ve settled on, let’s try again because it is a good website with lots of photos I can’t copy:  Hacienda La Jacaranda and I just tested it and it worked, but just in case, here is the address:  http://www.atenasapartment.com/ And yes, I have a two bedroom, so a guest room for you!  Knowing I can get off the plane and go to my new home is the first big relief! Pura Vida!

MY “TRAVELING” BIRTH CERTIFICATE (Arkansas Bureaucracy)
My one certified copy is old and I need to keep it, so I ordered a new copy that will be sent to Costa Rica. I finally got a real person to talk with and told her I needed my birth certificate with an Apostille (An international seal of certification) on it. “Oh, I’m sorry sir, we don’t do that in this office, but I will transfer you to the person who does.” Riiiiinnnng. “Secretary of State Office.” I again explained what I wanted. “Oh yes sir, just send your Birth Certificate to us and we will place an Apostille on it.” I then explained that I needed a new one and asked if the two offices could work together to place the seal before mailing it to me. “Oh no sir, I’m sorry, you will have to personally mail it to us with a cover letter and $10.” So I ordered the birth certificate online (fairly easy) and got it Express UPS in 2 days! Then I added my letter and check for $10 which is better than the $40 for the certificate! It has now been sent back to Little Rock in another Express UPS envelope ($20). When it is returned my birth certificate will have made three trips between Little Rock and Nashville before I send it to San Jose. I remember complaining how bureaucratic the Gambian government was (and have been warned to expect with Costa Rica), but I think we are just as bad in the states! Pura Vida! 
SOCIAL SECURITY, TALKING COMPUTERS (and one real person) 
Yesterday I spent more than an hour trying to get a certified, signed letter proving I make at least $1,000 or more per month. The SS Website is confusing and after talking computers, the recording for live customer service says “an hour or more wait, so press 1 for a call back.” They never called back. I did find a “statement of SS Income form online and printed it, but it’s not a letter and I’m afraid not official looking enough to satisfy the Costa Rica government. 
So this morning I talked with a real person quickly at our local Madison SS Office and after one minute of data collecting, he very business-like said “I’ll get that out to you today sir.” No discussion, excuses or wasted time, just done! Hey! I like that! So the second document needed for my residency application is on its way. (I hope!) Police report on me is next job to tackle. Pura Vida!
BIG JOB OF SELLING STUFF, DOWNSIZING
I started with some videos on eBay and plan to add some books and other items there as I go along. McKendree Village is starting a “Village Treasures” Shop on October 11, in one of the unused cottages up front, which is just what I need since we are not allowed to have yard sales. It will more often be used for older people who move to nursing home or die and need to dispose of furniture and household goods. I’m already boxing up household goods for them and will pick some art or some of my many framed photos. I’ll have Jane & Scott come over and assess my stuff soon. This is in many ways the biggest job, because I want to limit what I put in storage and maybe later ship to Costa Rica. But life is not stuff! Pura Vida!
NEW REVELATIONS ON INTERIM MEDICAL INSURANCE
I plan to go on the more affordable government health plan called CAJA after I gain residency, which will take 6 months to a year. The most affordable interim option presented to us in the seminar (though not real cheap) was a PRICOSE private INS Health Insurance. I’ll do it for a year until I can get the CAJA. I wrote the PRICOSE representative who talked at our seminar, telling him I wanted to enroll before January 1 to be covered as I arrive. “Sorry,” he says. I will have to be in country and apply in person with a local attorney’s affidavit, a full physical by one of their doctors including a $130 EKG. The whole process will take about 5 weeks after I arrive. Brick wall I thought! Okay, so now I have to arrange for about two months of overseas or travel coverage until I can get their coverage. I’ll call “One Exchange” today.

“One Exchange” is the proxy for health coverage plans for LifeWay Retirees. They mainly help you pick out a policy that they sell you for their percentage. I talked to two people, the last of whom kept putting me on hold while she talked to her supervisor. They are all ignorant of what to do and even though I told them what my research indicated was possible through a Medigap Plan for 60 days, they knew nothing about it and said they would have to research it and get back with me. A big waste of 45 minutes!

Then I call my Medigap Insurer, Mutual of Omaha, and told them what my research showed and asked if my Medigap was one with the overseas coverage. They were the opposite of One Exchange. Misha was knowledgeable, polite and helpful. In just a few minutes she confirmed my research and told me that my Mutual of Omaha Medigap will cover me overseas at 80% for the first 60 days for all medical expenses that Medicare would cover in the states with a $250 deductible and $50,000 maximum. That will give me 60 days to get the Costa Rica policy I was told would take 5 weeks (35 days). I will not cancel my Mutual of Omaha Medigap Insurance until AFTER I have the local policy in hand as recommended by Mutual of Omaha and common sense, in case something doesn’t work out. (If INS took longer than 5 weeks and I have an emergency, I can fly home and be covered as I am now.) I am so relieved about something that was beginning to be a concern. There is now a plan in place to keep me with medical insurance at all times during the transition. I believe I will make it through this move just fine! Due diligence, planning and proper timing pays off!

Pura Vida! (A Costa Rica slogan, literally meaning “Pure Life” but used to express the joy of life, happiness, greetings, etc. The above efforts are part of my cost to soon gain Pura Vida!)

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The Decision is “Yes”

Most people I’m around already know that, but the purpose of this blog was to lead up to the decision and now future blogging will be on my “Adventures” blog. That is what this will be whether I stay only a year or the rest of my life, everything about Costa Rica is an adventure!

I did a four-page Excel spreadsheet giving various categories of life 1 to 5 points in column for the U.S. and for Costa Rica. I will not attach the spreadsheet. Be aware that even though I was trying to be objective, it is probably still more subjective and my heart is probably leading more than my mind, though I am still trying to be “rational.” In this tally Costa Rica won 76 to 68 which is actually pretty close!

IN SUMMARY

It is nature that has been attracting me to Costa Rica for years and what I loved best about the four times I have visited. Birding, hiking, nature photography is simply better here than anywhere I have been. My #1 reason for going. Because it costs all of my fixed income to live in the States, I have been, maybe foolishly, using savings for these trips, which must stop, thus . . .

Financially I have figured out how I can live for less there (where I like to travel) and save for trips or future emergencies which I haven’t been doing a good job of in the States. Now be aware that my cost of living will be lower there only if I live like a local. It is actually the most expensive Central American country, mainly because of the high cost of imported goods (especially cars). Thus I will try to “eat local” which will cost less and be healthier. Shopping too much at Walmart (which is there) could blow my budget!

Weather is a big trump card for Costa Rica. Atenas, where I am now considering an apartment, was declared by National Geographic as “the best climate on earth,” averaging 72 year-around or always between 65 & 85.

The culture/people is the best I have experienced anywhere, friendly, welcoming, often rated the happiest country on earth, no ethnic/racial conflict, religious though differently than me, educated, conservation-oriented, economically sound, democratically elected government, and a good blend of the modern and the historic. I am a follower of Christ wherever I live and there will be a fellowship of Christians I can become a part of and it could even be Baptist, but may not be.

Super public transportation which will replace my car and another way I will save money.

One of the best healthcare systems in the world with choices of both private and public programs.

Volunteer opportunities abound including IN Bio which may replace my beloved Nashville Zoo and of course schools, church, other conservation efforts.

Language & Stuff are two challenges. I’m in a Spanish class this fall in Nashville and will get in one in C.R. soon after arrival. I will again downsize, getting rid of some stuff and storing the rest for at least a year before I decide on what if anything will be shipped to Costa Rica.

What will I do? Nature photography, more photo books, maybe sell to tourist shops, writing, reading, hiking, helping other people in multiple ways, and finding new ways of worshiping God. I have never been without something to do and always love the experience of adventure. So from here on, you may follow my adventures on my Retirement Adventures Blog. It begins now in preparation for the move. And every once in awhile click on one of those ads on my blog. I get paid a few pennies for every click!  🙂

And remember, I lived three years in The Gambia, West Africa, my favorite place to have ever lived, and it is a true 3rd world country with pitiful healthcare and corrupt government. So Costa Rica will be a real vacation for me!