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Caja Fees Increase

What is Caja?

One of the requirements for getting your residency status and having your DIMEX card (ID card) in Costa Rica is to enroll in the national healthcare system (Caja) upon approval of your residency application.

Caja (CCSS) – Costa Rican Social Security Fund ( Caja Costarricense de Seguro Social).
You have to be a member of the Caja and pay a percentage based on the income level you declared when you applied for residency.

There are public and private healthcare systems in Costa Rica. Many foreigners and ticos use both. If you are in a rush for anything that isn’t too expensive, then private clinics are a better choice. If you can stand the long wait periods in the public system for more serious concerns, then it’s better to obtain your medical care at Caja, which has a high standard of medical care as well.

 

Caja System

The Caja system consists of 2 elements:

  1. Healthcare coverage – SEM (Seguro de Enfermedad y Maternidad);
  2. Pension contributions – IVM (Invalidez, Vejez y Muerte), similar to SS in the USA or CPP in Canada.

Before, only the SEM payment was imposed on retired and investment residents. As for the IVM, the regulation specified that individuals could opt out of contributing to it.

 

New changes

As of March 16th of 2022, Costa Rican Social security rules and regulations have changed, facing a significant rise in Caja rates expenses…

Immigrants must now have both SEM and IVM insurance, according to the reform, meaning both Healthcare and Pension plans. Six months after the update was published, it took effect on March 16, 2022. Residents who apply as retirees or investors will be subject to the new CAJA rates as of this date. Rentistas are also included, but they are not mentioned explicitly in this new regulation.

Costa Rican law prohibits the adoption of new rules retroactively. As a result, people who signed up with Caja BEFORE MARCH 16, 2022, do not need to be concerned about these recent changes; they will not be affected.

 

How it works

Pensionado – you will have to provide Caja with your Proof of Pension (the same as you submitted to Immigration with your residency application earlier). Based on your pension amount, they will calculate your monthly payment.
Rentista – Caja will use the $2,500 USD per month income out of your bank account in Costa Rica.
Investor – officially not specified yet.

 

Example

1) Pensionado with $1,500 USD per month income:
(1,500 x 6.24%) + (1,500 x 7.20%) = $201.6 USD monthly Caja payment.
 Before: you had to pay 6.25% (for 1 plan, SEM)
Now: you will have to pay 13.44% ( for 2 plans, SEM + IVM)

2) Rentista with $2,500 USD per month income:
(2,500 x 8.2%) + (2,500 x 7.65%) = $396.25 USD monthly Caja payment.
Before: you had to pay 8.02% (for 1 plan, SEM)
Now: you have to pay 15.67% (for 2 plans, SEM + IVM).

As you see, the Caja payments have almost doubled…

 

Solution

It’s uncertain if this ill-conceived system modification will continue to be the case in the future or not, but only the outcome of future appeals will tell. The new administration, which will be sworn in after the runoff election, may also provide further assistance in reversing or adjusting these rates.
It’s necessary to make a lot of noise about this issue in public forums, embassies, etc., to put pressure on the politicians and bureaucrats who can change it.

When compared to other countries, the Costa Rican healthcare system, despite its shortcomings and challenges, nonetheless provides greater value. Medical tourism is growing in its popularity immensely. One of the primary advantages of living in Costa Rica is the year-round availability of its unique healthy environment. Let us focus on what is still of really great value.

From our side, CRIE is working with a network of independent attorneys on preparing the appeals, which we hope will contribute in changing this regulation for a more fair solution.

This Post Has 13 Comments

  1. Well I’m not fully retired yet just partially at this time. So now this increase for Health Care is really extremely harsh.. How is they say retirement financial amount is $1,000 but they want more than 200.00 of that per month for health insurance. USA already does this anyway. And why do you need to pay for two different kinds now??It seems to me this is another government policy to make them more money and to push out retirees.. This situation is blantley Harsh no consideration for the people who want a Pensionado

  2. Very confusing situation. For instance, one expat took it upon herself during a recent visit to her Caja office to inquire about the new IVM contribution requirement. According to them it does not affect 65 and up,
    I have also read that certain ongoing expenses may affect your contribution, but that is rarely mentioned in the “Here’s your cost of living in CR” articles.
    Note for Gloria…
    The example given was for a $1,500 income. You would still be in that 13.4% bracket, but at $1,000 (minimum Pensionado income) the amount would be roughly $134, far less than my costs under US Medicare!
    Personally hoping for a clarification that exempts 65 and up from the pension portion of el Caja.

  3. frankly this may very well price me out residency.
    i’m going to be receiving US social security in a few months, three years before i’m 65.
    i don’t even see there is any benefit to the additional charges.
    as retired military, i get my healthcare almost free in the US so it’s all just a gouge to me.

  4. This may be a silly question, Is this cost per each individual? I’m married and the one with the pension. Trying to make we are not priced out. Thanks!

  5. Question: Caja for Pensionados – is it as follows:

    1) Income – less expenses. (*do you need receipts if this is the case? I don’t get receipts as I
    Shop at the Farmers Market for most of my food, and local grocery markets (have those receipts), and rent a room and have never asked for a receipt), transportation is public transit, unless I get a ticket from the metro station, I don’t get receipts.
    2) If over 65 is the Caja under the old rules of 6.5% and not the new Vat of 13.5%
    3) Any info on Law 9996 – I know it’s passed, pending implementation.

    Thanks for any info.

    1. 1)The expenses are not important. Your income is the only thing that matters. You only need to prove that you receive not less than $1000 USD per month.
      2) Caja rules are the same for everybody who signed up after March 16, 2022.
      3) No, this law hasn’t passed yet.

  6. Omg I’m a new DIMEX resident and this is extremely difficult for me to pay si I’m in desparate need to know if I have to purchase the Cajon medical ins. or can I switch to Bluecross Blueshield which gave me a lessor estimate whuch I could afford. But not sure if its a problem with immigration Thx any info greatly appreciative.

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