Upe! Upe!

Moving to a foreign country is scary enough without having to find a good doctor or dentist upon arrival. At 58, I was moving to a remote mountain area in Costa Rica and my Spanish was extremely limited. It seemed prudent to have everything done prior to leaving the U.S. I knew eventually I would need medical care but I felt secure in knowing that the United Nations ranks the healthcare system in Costa Rica as the best in Latin America and one of the top 20 in the world. In doing my homework I was relieved to learn that first rate care is available in San Jose where most doctors, at the private hospitals, have training abroad.

The National Insurance Institute or INS offers medical policies to permanent residents and even tourists. I found an English speaking agent in San Jose to explain the system. By U.S. standards, the rates are very reasonable.

Prior to receiving my identification card from INS, I had a small emergency. I went to the emergency room of a rural hospital and was seen within an hour, given a shot for pain, and x-rayed. I was asked my name but no one seemed concerned about payment. The Dr. spoke Spanish to me using enough English to assure me that I wasn’t dying. I left without paying a cent and I never received a bill.

As a permanent resident I have traveled to Cima Hospital in San Jose, which is affiliated with the Baylor University Medical Center in the U.S., for preventative health care. I was impressed with the care on both occasions. I paid $60 for a routine mammogram and an ultrasound which is standard procedure here. A visit to a specialist, including an injection for a pesky shoulder, cost $40 These are big city prices at private hospitals. If you are willing to go to the public medical facilities with long lines and bureaucracy, the cost is much less and the treatment probably as good. Most private specialists are required by law to work part-time in public hospitals.

Surprisingly, there is a Doctor who comes here from the mainland once a month to treat varicose veins. This sounds highly unconventional especially since he does the injections in a private residence. I was skeptical and resisted even going to talk to the man for over a year. When I did, I met a quiet, unassuming, gentle, man. He spoke English and French having lived and trained in both France and the U.S.

It was a bit disconcerting to go into a bedroom and lay down on someone’s bed to have the injections. There are no overhead surgical lights; the Dr. brings a little lamp. Everything that touches my skin is sterile and the bandages are clean because I wash them and bring them each visit. I have ten to fifteen injections each visit and it costs $44. I’m extremely pleased with the results. I felt I couldn’t afford this cosmetic surgery in the U.S.

There are expats who would never seek the services of the local country doctors. When my $800 gold crown fell off the other day, I debated whether to take the four and a half hour bus trip to San Jose or try the local dentist.

The crown was done prior to leaving the U.S. not in a dental office but at a dental “studio”. There was no waiting room but a lounge area with designer chairs and quality artwork abundantly displayed.  The dental chair floated seemingly in space and the patients gazed at a waterfall dripping languidly over an entire wall. It was impressive! So were the bills!

It was quite a different experience at the dentist here. His hand made sign which looked a bit like a ransom note, had fallen down. It was propped up in the yard against a tree. I almost turned around to go but he came out the door and greeted me. There was an extremely small but clean waiting room. The dentist ushered me into the chair and closed the door behind him. The first thing I noticed was a large elaborately framed picture of a water fall on glass. There was a light behind it causing the water to have the appearance of falling over the rocks. I believe there are no coincidences, only spiritual puns. I took it for a sign.

Several times during the procedure, I would hear, “Upe, Upe” and the door would slide open. His patients were announcing themselves or asking how long he would be with me the “gringa”. The equipment was old and instead of tying a bib around my neck, he handed me a paper towel. It was a sterile environment but basic. I was nervous. He asked me if I wanted anesthesia which seemed like a silly question. When he gave it to me, it was smooth and painless. I relaxed. He explained how I would need 3 visits and drew little pictures in explanation on the back of what looked like his grocery receipt. It will be around $150 total. When it was time to go, I paid him directly. I made my next appointment by writing my name and telephone number down in a little book with a calendar. It was so easy, no forms, no checking insurance, I was charmed.

If you come to Costa Rica as a tourist and need emergency surgery, payment can be made at most hospitals and clinics with a credit card. Foreign medical health insurance is not accepted. The average cost of a hospital room at a private hospital is around $150 to $200 per day. More importantly, you will receive first class care at any of San Jose’s three largest private hospitals. If you visit my area and need a dentist, I’ve got just the guy!