Vaccinations
Insurance
Medical Facilities
Doctors
Having a Baby
 

Vaccinations:
Before you come, you should make sure your vaccines are updated.  You can get inexpensive shots at the Health Department (on Palouse River Drive in Moscow 882-7506).  The Center for Disease Control recommends the following vaccinations:

• Hepatitis A
• Hepatitis B
• Typhoid
• Yellow Fever
• Tetanus/Diphtheria
• MMR
• Rabies (optional):   The Clinica Biblica in San José has rabies shots. They do have the vaccine- however they wanted to give me (Ruth) the whole series rather than the preventative shots. To buy the vaccine you need a prescription, which I didn't have so I had to pay for a visit with the emergency room doctor. They let me get one shot and buy two more, which I took back to CATIE.
  
  So apparently you can get the follow-up shots here.... even if you don't need them... I think they are not used to people wanting preventative shots.

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1. UI Insurance:  Klais & Company 800-331-1096
   UI insurance will work for you down here, but they only pay 70% of the medical costs after you have met the $500 deductible.  You have to pay the medical costs upfront then submit receipts for reimbursement. 
   
   The UI insurance now includes evacuation and repatriation of remains which is required by UI if you are going to study abroad.  The coverage is provided by a separate company, Assist America. On their website it says they issue you a card, and that you should contact them before leaving.  They offer lot of helpful services besides the emergency stuff, they will advance funds to a hospital if it doesn't take your insurance, pay for a family member to visit if you are hospitalized, and other things.  You can contact them at:
   
   1-800-872-1414
   1-800-304-4585
   301-656-4152 (collect call from outside US
    
2. ISIC (International Student Identity Card):
   Becoming a member of ISIC gives you benefits including discounted airfare as well as evacuation and repatriation of remains insurance.  This is required by Study Abroad in the International Programs Office (IPO).  To get a card you need to take a passport photo and $40 to IPO (2nd floor of Morrill Hall).  You will have to renew this every January.
   
   *This may not be necessary now since the UI insurance covers evacuation and repatriation of remains.  Check with IPO.
    
3. CATIE/Costa Rican health insurance:
   1. As a CATIE student, you are eligible for the Rutherford Health and Life Insurance plan which costs $650/year.  The plan has a $50 deductible then it pays 80% of all medical fees.  You pay upfront and submit receipts through Janette Solano (506) 558-2421 to get reimbursed.  Dental and vision are not included.  It does NOT cover the student's family.  Noily Navarro (558-2630) can give you more details about exact coverage.
       
   2. As a CATIE student, you AND your family are eligible for the Costa Rican state health insurance.   It costs $40/month for you and your family and provides free medical coverage including generic prescriptions.  However, you must use network doctors and facilities.  If you choose to use a non-network doctor or hospital, you will have to pay for it on your own.  Talk to Jeannette Solano (558-2421) or Noily Navarro (558-2630) to sign up for El Seguro de la Caja.

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MEDICAL FACILITIES:

• US Embassy List of Facilities
• CATIE
  Limited medical services are offered on campus. 
  
   If the doctor/nurse cannot attend to your needs, they will send you to the appropriate clinic, hospital, or pharmacy with an order or a prescription.  These services are free if have the state insurance, but they are very nice and willing to help anyone.  The medical office is located behind the Henry Wallace building.  558-2298.
  
  M W:       12:30 -  3:30 pm
  T TH F:     7:00 - 11:00 am
  
  There is a dentist who comes to CATIE every Monday and Tuesday.  She does check-ups, cleanings, fillings, etc.  A cleaning costs around $20.  Talk to the CATIE nurse to make an appointment and to see a price list.
   
• TURRIALBA
  The William Allen Hospital in Turrialba can deal with most emergencies; if not, they will ship you to Cartago or San José.  The services are free if you have the state insurance.  556-1133.

  Other clinics and pharmacies in Turrialba include:

  • Clínica de Especialidades Médicas Dr. Francis.  556-0191
  • Farmacia Colón.  556-6020
  • Farmaria San Buenaventura.  556-0131
  • Laboratorio Clínico Dra. Carmen Leiva.  556-1516
  • Optica Bellavista.  556-6158

   

• SAN JOSÉ:  San José has several large hospitals to choose from including:
  Clinica Biblica (506) 257-5252
  CIMA (506) 208-1000
  Clinica Católica (506) 246-3000

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DOCTORS:

US Embassy List of Facilities
The following are recommended either by CATIE or the US Peace Corps:

• General Practitioners
  Fernando Francis...................................... 556-6122 T
  Eduardo Sibaja..........................................556-0854 T
  Alvaro Zúñiga............................................. 556-6104 T
   

• Internists

  Dr. Kafarela................................................208-1503 SJ

  Dra. Byfield..............................240-9044, 297-0424 SJ

   

• Gynecologists
  Milton Frances............................................556-6122 T
  Raymundo Riggioni................................... 556-0209 T
  José Sancho.............................................. 556-1349 T

  Dr. Adam Paer................201-720 x 111, 384-8997 SJ
  Delia Ribas..............................257-1287, 233-3953 SJ
  Dr. Escalante..............................................257-1287 SJ

  Dra. Kim..............................  208-1210, 1208, 1209 SJ

• Midwives

  Rebecca Turecky....................556-5615, 359-1881 T

  Marie Tyndall...............................................293-6613 SJ

• Pediatricians
  Juan Carlos Santa María......................... 556-0840 T
  Braulio Alfaro Brianso...............................253-9118 SJ
   

• Dentists
  Marcos Ique...............................................556-0218 T

  Dr. Lachner................................................253-9365 SJ

  Dr. Castro...................................................290-2121 SJ
   

• Dermatologists
  Dra. Naranjo......................................800-911-0800 SJ

  Dra. Hernandez.................................800-911-0800 SJ

• ENT

  Dr. Moises Majchel Waintraub...............221-1120 SJ

• Orthopedics

  Dr. Ricardo Castro..................................222 0366 SJ

  Dr. Jaime Ulloa........................................222 0366 SJ

• Optometrists

  Dr. Joaquin Martinez Arguedas............282-8815 SJ

• Psychologists

  Sandra Quiros........................................222-4119 SJ

• Chiropractors

  Danilo Sanchez Chavez........................268-8684 SJ

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Having a Baby:  Here's some helpful information if you are planning to have a baby while living in Costa Rica.  Make sure to plan ahead because it takes a couple of months to do all of the paperwork for you baby to get a US passport and to be able to leave the country.

• Cost:  The cost will range from $500 if you use the national insurance plan and state hospitals to $5000 (you get 70% back) if you use UI insurance and a private doctor.
   
• Things to bring with you: 
  1. Original or certified copy of your Marriage License
  2. Passports
      
• Insurance
  1. UI insurance (Klais & Company):  Klais pays 70% after the $500 deductible of all the prenatal and birthing bills.  However, you must pay for everything up front and get reimbursed after you submit receipts.  Any lab tests, ultrasounds, etc. can be submitted along the way, but the monthly doctor check-ups and final hospital bills cannot be submitted until after the baby is born.  To submit a claim, you need copy, translate, convert currency, and fax to Klais. (This process could vary if Klais changes their policies.)  You can choose state or private facilities and doctors using UI insurance.
  2. Costa Rican insurance:  El seguro de la caja costs around $40/month for the entire family and it covers all doctor visits, medicine, hospitals, and most lab work, if you use state facilities.  Talk to Jeannette Solano (506) 558-2421 to sign-up for this insurance.
      
• Adding the baby to UI insurance:  fill out the Adding Dependents to SHIP form and fax it along with the birth certificate (Certificado de Declaracion de Nacamiento) to Katherine Clancy at 208-885-9209.
   
• Hospitals:
1. Turrialba State Hospital 556-1133
   1. Advantages:  10 minutes from CATIE, basic birthing facilities
   2. Disadvantages:  If complications arrive, you will be sent by ambulance to Cartago (1 hour).  Recovery rooms with about 10 beds per room.  1 hour/day visiting hours which includes your partner.  Birthing room has 3 beds separted by curtains, and the husband is generally not allowed to attend the birth.  They only use the ultrasound for emergencies, not for monthly check-ups.
2. Clinica Biblica (506) 257-5252
   1. Advantages:  Modern facilities, individual recovery and birthing rooms, beds for the dad in the recovery room, good food, private bathroom, cable TV, safe, cheaper than CIMA.
   2. Disadvanges:  In San Jose (about 2 hours from CATIE), more expensive than a state hospital, seguro de la caja will not pay for services here.
3. CIMA (506) 208-1000
   High Quality, modern, expensive, private hospital which private doctors need to be affiliated with in order to use the facilities.
4. Clinica Católica (506) 246-3000, (506) 283-1571 - maternity
   High quality, modern, easy access
5. Others:  There are several other hospitals around which you could check into.
    
• Gynecologists:
1. State Doctors:  In Turrialba there's a team of several doctors all of which you may see depending on the time and day of your check-ups.
2. Private in Turrialba: 
   1. Dr. Milton Frances lives in San Jose, but he comes to Turrialba on Wednesdays and Saturdays to see patients.  The CATIE staff really likes him.  556-6122
   2. Dr. Rojas is a seguro de la caja doctor but will also take patients in her private practice.  She lives in Turrialba.
3. Private in San Jose:
   1. Dr. Ribas and her husband Dr. Escalante live and work in San Jose.  They are recommended by the Peace Corps.  257-1287.
   2. Dr. Adam Paer lives and works in San Jose.  His parents are Americans, but he was raised in Costa Rica and married a Tica.  He is the most "natural" doctor in the country and usually chooses not to use interventions during labor.  He is a major proponent of water births in the SJ hospitals.  He is also very supportive of having doulas or midwives in the hospital to help the mom. 201-720 x 111, 384-8997
       
• Midwives:
  1. Rebecca Turecky is aUS trained American nurse, has a doctorate in nursing and is a trained midwife.  She lives in Turrialba with her Tico husband and two children.  She will help with home births or help the mom at the hospital.  556-5615, 359-1881.
  2. Marie Tyndall is a Canadian and a licensed midwife who practices in San Jose.  She often works with Dr. Adam Paer and will help with home births.  293-6613.
      
• Pediatricians:
  1. Dr. Juan Carlos Santamaria is a good pediatrician in Turrialba.  He charges ¢10.000 for an office visit.  556-0840.
  2. Dr. Braulio Alfaro Brianso is one of the top pediatricians in the country.  He is the head of the state children's hospital, but he also has a private practice. 253-9118 or for emergencies 233-3333
      
• Birth Certificate
  You will need a Costa Rican birth certificate to get the US and Costa Rican passports as well as the Consular Report of Birth Abroad (this will serve as the birth certificate in the US).
  1. The hospital will give you a Certificate de Declaracion de Nacamiento (this is NOT a birth certificate) which you take to the Registro Civil (near the park in Turrialba, diagonal to Compra Mas)  where they will start processing the birth certificate.
  2. The birth certificate will take about 2 months to process.
  3. To pick up the birth certificate at the Registro Civil, take the Certificate de Declaracion de Nacamiento and about five sets of timbres ~¢45 each (stamp-like things that you buy at the Municipio).
  4. At the Registro Civil, tell them that you need five original birth certificates that allow the baby to leave the country, the kind that require timbres.  You will need copies for:
     1. Costa Rican passport
     2. US passport
     3. 3 to take to the US as originals
         
• US Passport and Consular Report of Birth Abroad 2.5 hours, ~$135
  US citizens can conduct business at the embassy from 8:00am-11:30.
  US Embassy (Calle 120 Avenida 0, Pavas, San José - west of Parque Sabana, Tel: 506-220-3050 x2452, Fax: 220-2455)
  1. The Embassy has a list of what you need called "Documents required for requesting the birth abroad of a United States citizen".  Check their website.
  2. Fill out the Application for Passport and Citizenship request which you can get at the embassy and possibly online.  Be sure to fill out the section on the back of the Citizenship sheet to get a social security number at the same time.
  3. Both parents and the child MUST be present at the Embassy to request a passport.
  4. You will need to take:  Passport Application, Costa Rican birth certificate, statement from the physician who attended the birth, an original and certified copy of the marriage certificate (otherwise they'll keep the original), certified copies of previous divorces, original passports, copies of the parents passports (photos, visas, entrance to Costa Rica), two passport photos
  5. Go in the embassy and follow the signs to "passports" (Don't wait in the Costa Rican visas line!) and take a number.
  6. Go just outside the passport office and have the passport photos taken ¢1000.
  7. When your number is called, go to window C (the left window) to turn in your paperwork
  8. Pay $65 for the Consular Report for Birth Abroad and $70 for the Passport at the cashier's window.
  9. Wait for your name to be called and go to window D (the right window) to verify your documents and take an oath that everything is correct.
  10. Your passport and consular report for birth abroad will be ready in 10 days.  Go back to window D.  Don't wait in line, just go directly to the window.
       
• Costa Rican Passport  2 hours, $26
  The lines are shorter early in the morning
  1. Apply for a Costa Rican passport at Migracion (near Hospital Mexico on the way to the airport)
  2. Both parents and the child MUST be present
  3. You will need to take: copies and originals of passports, original birth certificate
  4. Follow the signs to Gate 6, then pay $26 at the caja just to the right of Gate 6.
  5. Give your receipt and papers for review to the person at the desk.  Ask for a Salida del pais papers (pink sheet).  Make sure to mark permanente NOT temporal.  Temporal only allows one exit and expires in 30 days.  Permanente is good for lifetime.
  6. Go to the special seating are to the right (for people with babies, etc).  Don't take a number, just wait in line.
  7. They will take a digital photo of the baby and enter the information electronically.
  8. You can either pick up the passport in 2 days or have it sent to you in about 4 days.  If you want it mailed, ask for a receipt and take it to the Correo office to the right.  It costs ¢1500 to have it mailed.
      
• Social Security Number
  You can request a social security number on line from Social Security Online or you can call 1-800-772-1213

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