CAJA (Healthcare) Monthly Premium Issues

Date

Applicants approved for legal residency in Costa Rica must enroll in CAJA (CCSS – National Healthcare) as a condition of residency. (Step 2 of 3 in the post-approval process). 

Effective March 16, 2022, anyone enrolling in CAJA also had to enroll in the Costa Rica Pension plan. This resulted in a significant increase in monthly premiums. (see the chart below). That rate increase also ignited a firestorm of protest on social media and my email inbox.

Concise update:

After a year of not seeing the promised fix to the situation, beginning in June 2023, I have been communicating directly with the Costa Rica Office of the President. They were quite responsive. After initiating his direct communications, President Rodrigo Chaves’ head of administration connected me to CCSS’s (CAJA) top management and promised to monitor how CCSS responded. Since then, all email communications between CCSS (CAJA) and myself have been copied to that same Presidential head of administration.

Long story short: 

I’ll spare readers the details of my months of hold-my-head-in-my-hands frustration battering against the CCSS (CAJA) bureaucratic labyrinth. (It is a mammoth organization.) Bottom line: I finally met with the top brass this past January 9, 2024, at the head offices in the Sabana part of San Jose. I had an excellent exchange with people who impressed me as competent, concerned, and capable of fixing this poorly thought-out regulation instituted by previous CCSS management under the previous government.

On February 8, 2024, I received a progress report email from one of those individuals (whom I will name in future updates), stating that a formal request has been made to rescind the Costa Rica Pension participation mandate for foreign migrant enrollees. The intent is to restore the previous mandate of healthcare coverage only.

The following chart, which I included in previous articles, shows the two categories of rate calculations. The goal is to see the elimination of the second box (Chart B – Pensions) soon.

Sample calculation based on # 3 in both charts:

Chart A #3 – Monthly income of USD 2,445 x .0624 = USD 152/month for (CAJA) coverage.

Chart B #3 – Monthly income of USD 2,490 x .0720 = USD 179/month Pension fund contribution.

The total combined CAJA monthly premium would be USD 331. (March 2022 – slightly higher since then).

A formal request has been made to the CCSS Pensions department to eliminate Chart B. When eliminated, and using the example above, the new monthly premium would be USD 152/Month. (Instead of USD 331)

For Pensionado residency applicants, CAJA offices have been allowing expense deductions when enrolling. But not so for Rentista and Inversionista enrollees. Those CAJA rates are determined by using a monthly income of USD 2,500/month for Charts A and B and not allowing any expense deductions at enrollment to lower the net monthly income used to calculate the rate.

I will post an updated article after receiving news on this long-awaited change. In the meantime, I encourage you to be patient and avoid making drastic decisions. We have been down this road before.

I confidently expect it to end well.

Laura

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