Monday, March 23, 2009

Public Health Care - Ebais Clinic

I picked up some germ or other last week, and finally had occasion to visit my local public health clinic. These small doctor offices are called "Ebais" - the one you go to is determined by where you live. Ours happens to be just a block and a half away :-). Strange as it seems to gringos, everything at the Ebais is free (that is, it is 100% covered under the CCSS public insurance).

To see a doctor, here's what you have to do:

1) make sure you are affiliated. When you first move into your new home, find the local Ebais and register. You take your CCSS receipt (and your last CCSS card, if you have one), and your cédula. If you are a family covered under one receipt, you need to go together and take all relevant certificates (marriage, birth); these have to be "recent" copies (The definition of "recent" varies from less than 3 months to less than 6 months. Don't ask me why a birth certificate has to be recent.). Our Ebais only did affiliations between 8:30-12:30 and 1 and 2, Monday through Thursday. When you register, you get a new card and (maybe) an appointment booklet. You are encouraged to "plasticize" your card (there are street-side vendors who do this). This CCSS card is also called the "Carné del Ebais."

2) make an appointment. Go to your Ebais at about 6:00 a.m. and wait in line. This morning, we got there at 6:15, and there were 25 people ahead of us. The doors open a bit before 6:30, everyone files in and takes a number. When you number is called, you go to the window and show your CCSS card, appointment card, receipt, and cédula. You get an appointment for later that morning (e.g., 8:45 and 9:45).

3) see your doctor. Take a copy of your medical records to leave with them (you should bring these from your previous doctor). Don't expect anyone to speak English. To make it easier, you will probably want to write out your symptoms in Spanish ahead of time. Pointing and miming also helps. You will see the nurse first, then go back out to the waiting room until the doctor calls you. When you are done with the doctor, you take your file back to the desk and finish up any paperwork.

4) if needed, return for lab tests. Get there at 6:00, wait in line. When they open the doors, go directly to the lab line. A bit before 7:00, the lab opens. It is only open until 8:30. Show your lab request paper, get a number, and wait. If you need a urine test, you have to bring it with you, in your own (clean, dry) container. Jelly jars are common for this :-S.

5) if you need a prescription, return in the afternoon, between 3 (farmacia opens) and 4 (farmacia closes). Bring your prescription receipt to the farmacia window. I like to write down the names from the doctor and check them online before I get them - then I can look up and ask any remaining questions when I pick them up. Sometimes, the doctor prescribes medicine that is not available at the Ebais - when this happens, the doctor tells you, so you know to go to a regular farmacia to buy it (and you get a written prescription for it).

Timing for recent appointments:
- 6:15 in line for appointment
- 7:10 got appointment
- 8:40 return to Ebais
- 8:45 appointment time
- 8:50 see nurse, then doctor almost right away
- 9:40 done with doctor; problem with CCSS card
- 11:00 problem resolved; have new CCSS card
- 3:00 return for prescriptions

- 6:15 in line for appointment
- 7:10 got appointment
- 9:40 return to Ebais
- 9:45 appointment time
- 9:55 see nurse
- 10:30 see doctor
- 10:40 done with doctor
- 10:50 done checking out

Special note: flu shots are available at the Ebais between February 2 and March 31, in time for "winter."


Anne said...

sounds like miami. oh, and calling yourself a gringo is rather akin to using the "n" word, just so you know...

Julie said...

Hi Anne - thanks for commenting :-D
But to clarify, in Costa Rica, "gringo" is not a "n"asty name. It is a friendly way of referring to folks from the USA. It is true, this is not the same for some other Latin American countries, but not something to blink over in Costa Rica.

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