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Lives

It is our local health plan, for Costa Rica, with a maximum coverage of US$100,000, available within the reach of people who require less health coverage that fits their budgets and lifestyle, with an annual deductible of US$200, coinsurance of the 10% within the network, without deductible in hospitalization or maternity and optional life insurance for US$50,000 or US$100,000.

General Information

Eligibility

• Permanent residents of Costa Rica. No age limit for issuance and renewal.
• Dependent children up to their 18th birthday or who are single and reside with the policy holder until their 30th birthday.
• Medical examination is required (the insurer reserves the right to waive the medical examination, based on a declaration of good health and / or evidence presented by the proposed insured.)

Deductible Options

• A deductible of US$200 applies per insured, per policy year, up to a maximum of 2 deductibles per family.
• Elimination of the deductible for Hospitalization, Pregnancy and Childbirth.
• Expenses incurred during the last 90 days of the policy year not exceeding the deductible will be applied to the next policy year period.

Hospitalization Benefits

* DOES NOT APPLY DEDUCTIBLE. COINSURANCE OF 10% OF THE FIRST US$10,000.00 APPLIES

Description	Coverage
Medical and surgical charges	100%
Room and Food (Max. 180 Days)	US$1,000 per day
Intensive Care Unit (Max. 180 Days)	US$1,000 per day
Medical fees	BMA
Medications During Hospitalization	BMA
Chemotherapy, Radiation Therapy and Dialysis (In-Network only)	BMA
Laboratories, X-rays, Magnetic Resonances, CT and Ultrasound	BMA

Outpatient Beneﬁts

* APPLY DEDUCTIBLE AND COINSURANCE

Description	COVERAGE
Ambulatory surgery	BMA
Fees for Medical Consultation	US$90 per query
Chemotherapy, Radiation Therapy and Dialysis (In-Network only)	BMA
Laboratories, X-rays, Magnetic Resonances, CT and Ultrasound	BMA
Medications After Hospitalization (Max. 30 days)	US$1.000
Outpatient Medications	US$1.000
Emergency room	BMA

Maternity benefits

* WAITING PERIOD OF 11 MONTHS

Description	Coverage
Pregnancy and Childbirth (No Deductible or Coinsurance)	US$3,000
Complications in Maternity and Postpartum	US$25.000
Newborn Coverage	US$25,000
Routine Immunizations	US$150

Other Beneﬁts

Description	Coverage
Treatment for injuries as a result of participation in non-professional sports	BMA
Emergency Dental Treatment as a result of an Accident	BMA
Reconstructive Surgery as a Result of an Accident	BMA
Congenital Conditions	BMA
Local Ground Ambulance	US$300 per event
Local Air Ambulance	US$7.000 lifetime
Organ transplant	US$100,000 lifetime
Intraoperative prostheses	BMA
Medical Equipment, External Prosthetics and Orthopedic Devices	US$500 yearly
Treatment for HIV - AIDS	US$5.000 lifetime
Medical Treatment for Accidents and Emergencies outside of Costa Rica (Deductible applies)	US$25,000 annual

Additional Coverage Riders (Optional)

• Term Life Insurance (US$50,000 or US$100,000)

Travel Assistance - Medical Emergency Transportation

BMI Access

Does not apply

BMI MD Live

Does not apply

Coinsurance

Coinsurance within the network vive Costa Rica

• A coinsurance of 10% of the first US$10,000 in hospitalization applies.
• After meeting the deductible, a 10% coinsurance applies for outpatient expenses.
• Elimination of coinsurance for Pregnancy and Childbirth.

Out-of-network coinsurance vive Costa Rica

• A coinsurance of 30% of the first US$7,000 in hospitalization applies.
• After meeting the deductible, a 30% coinsurance applies for outpatient expenses.
• Elimination of coinsurance for Pregnancy and Childbirth.

Waiting period

• Coverage at 100% for accidents and infectious diseases from the effective date,
with a 90-day waiting period for any other covered condition.

Emergency coverage outside of Costa Rica

• Emergency medical treatment outside of Costa Rica: US$25,000

Supplements

Does not apply

Information

• Information: