Medical Benefits
This top-tier employer-paid health care with PALIG includes inpatient and outpatient expenses, emergency care, routine medical checkups, maternity benefits, psychology, dental care and other wellness services. Learn more in the PALIG Medical Plan Overview.
Who is eligible?
You must be a regular full-time or part-time employee working at least 30 hours a week to be eligible for the Fisher Investments Costa Rica core benefits package. In addition, your legal spouse and/or children up to the age of 25 are eligible.
Resources
Enrolling is easy!
Our insurance broker and healthcare support team, Uniserse, will arrange a consultation to explain the healthcare benefits and assist you in completing your enrollment forms within five days of your hire date. If you are away from the office during their scheduled visit, please reach out to Uniserse directly to arrange a consultation.
You may enroll yourself or a dependent at any time. Your benefits will take effect as of the date of your signed enrollment form. (Note: It is important to submit your enrollment forms within 5 days of your hire date, otherwise you will have to complete a medical questionnaire and risk analysis. As a result, the effective date of your policy will be pushed back. Additionally, itβs imperative that new babies are added to your coverage within 30 days of their date of birth.)
Key features at a glance
Your PALIG medical plan keeps expenses to a minimum for outpatient and inpatient care at private facilities, as your costs are covered at 90% for most services.
- 3-month wait period for pre-existing conditions and no wait period on maternity
- Preventive care for employees and dependents
- 50 visits per year for physical therapy
- 30 psychology/psychiatry visits per year covered up to $100 at 80%
- International coverage
Telemedicine
Dial 4031-4000 to receive virtual medical consultations 365 days a year, from 6:00 a.m. to 10:00 p.m. You can also request general medical consultations at home and emergency ambulance transport. Each service has a low copayment cost with unlimited benefits.
Support team
Uniserse will help to coordinate any of your healthcare needs directly with the insurance company.
How your healthcare benefits work
Your Fisher Investments Costa Rica benefits give you affordable access to the private healthcare system in Costa Rica. ( Learn about Costa Ricaβs National Health Care System.)
The Costa Rican healthcare and insurance system may require you to work with an insurance broker or intermediary support team, especially for non-routine or more costly services. Fisher Investments Costa Rica has appointed a support team through Uniserse. They will help to coordinate any of your healthcare service needs directly with the insurance company, PALIG.
Check out SIGA!
After enrolling in the PALIG medical plan, youβll be able to access your account on the SIGA platform. On the platform, you can download the preauthorization and reimbursement form, upload claims, track your claims, check your plan coverage, update personal details and more. See your instructions on how to register to learn more. Please note, claims can be sent to PALIG directly, but the broker will be unable to assist with specific inquiries.
-
For primary care services, schedule an appointment by finding a network provider. Should you need help locating a primary care facility or if you require an English-speaking facility, please contact Uniserse via email at fi@uniserse.com (dedicated Fisher email address) or WhatsApp at +506 8647-3773 (+506 UNISERSE).
View instructions on how to find a provider. You can narrow this down by location and provider type such as doctor, hospital, clinic, laboratory and more. It is important to note that direct payment applies if you use the network providers.
-
In many instances, your healthcare expenses will be paid directly by your medical plan. You will only owe the amount that is your copayment, deductible or coinsurance, according to your plan benefits. However, there are several services that require you to pay upfront and submit for reimbursement, such as special benefits, preventive care, medication and ophthalmology.
Additionally, receiving out-of-network care will require you to pay upfront and submit for reimbursement. While you are permitted to use out-of-network healthcare providers, you will generally pay more if you do. The insurance company negotiates rates with in-network providers, keeping your costs contained and reasonable. You can expect in-network services to be covered at around 90%, while out-of-network services will generally be covered at 60%. Find in-network medical providers.
-
To file for reimbursement, you will need to request all medical notes, test results, a detailed invoice and refund forms completed by the treating medical provider. In most cases, the medical provider will be familiar with this process and will provide you with the necessary documentation to provide to your insurance company. Using the SIGA platform for reimbursement is recommended. From the platform, you can download the preauthorization and reimbursement form, upload claims, track your claims, check plan coverage and more. Follow these instructions to register.
Please follow these step-by-step instructions to submit a claim for reimbursement:
- Obtain a claim form here. You can also find this form on the SIGA platform.
- Complete all information, including the name of the insured, name of the patient, policy number, signature, ID number (cedula) and your phone number.
- Have the treating medical provider complete their section of the form.
- Upload all relevant information into the reimbursement request section of the SIGA platform.
- Remember to present along with the refund form: Test results, medical notes, prescriptions/medical orders, and original invoice with breakdown.
The estimated processing time is 15 business days.
*Important Information:
Please keep in mind, you have to present digital invoices per legislation specifying each service paid. Additionally, in case of any exams, medications, or similar services, medical references will need to be presented as well as any test results. -
Prior authorization from the insurance company is required for all procedures, surgeries, hospitalizations, physical therapy and preventive services. It is also required for tests and exams with a cost equal to or more than $500. If you do not get preauthorization for these medical expenses, your coverage will be at 60% instead of 90%.
To arrange a prior authorization, have your treating medical provider complete, sign and stamp a prior authorization form, which you can also obtain from the SIGA platform.