How to Navigate the Health System in Costa Rica

Costa Rica has a public and private healthcare system, both of which are available to foreigners. The public healthcare system is called Caja Costarricense de Seguro Social (CCSS) and is used by both locals and foreigners. It is generally recommended for minor medical issues, but for serious medical emergencies and major surgery, people usually opt for private hospitals. Public hospitals in Costa Rica are generally well-equipped and staffed, but the wait times can be long.

Costa Rica's Public Healthcare System

Costa Rica's public healthcare system is called Caja Costarricense de Seguro Social (CCSS). It is available to both locals and foreigners, and is funded by taxes and contributions from employers and employees. It covers a wide range of medical services, including doctor visits, hospital stays, and prescription drugs. The cost of public healthcare is relatively low, and there are no additional fees for foreigners.

Costa Rica's Private Healthcare System

Costa Rica's private healthcare system is used primarily by expats and digital nomads. Private hospitals are well-equipped and staffed, and offer a wide range of medical services. The cost of private healthcare is higher than public healthcare, but the wait times are usually shorter. Private hospitals are recommended for serious medical emergencies and major surgery.

Costa Rica's Top Hospitals

• Hospital CIMA San José: Private hospital located in San José.
• Hospital Clínica Bíblica: Private hospital located in San José.
• Hospital La Católica: Private hospital located in San José.
• Hospital Nacional de Niños: Public hospital located in San José.
• Hospital San Juan de Dios: Public hospital located in San José.
• Hospital San Rafael Arcángel: Private hospital located in Alajuela.
• Hospital Médica Bíblica: Private hospital located in Heredia.

Health Insurance Companies in Costa Rica

The most popular private health insurers in Costa Rica are Blue Cross, Blue Shield, and Mapfre. These companies offer a wide range of health insurance plans, including plans for expats and digital nomads. Expats and digital nomads typically use these companies, rather than specialized expat health insurance providers.

Insider Tips from Expats in Costa Rica: How to Navigate the Health System

"I moved here in the middle of a 5 year treatment plan. I retired early, and had no medical insurance. To stay on my treatment, I was able to buy the medication OTC for $60 a month," commented one expat living in Florencia, Costa Rica.

"In addition to general practice physicians, dentistry services and physical well being facilities, the area offers specialized care physicians who attend to the area residents. Local general care physicians offer the use of their offices for this specialized service such as women's health care, cardiology, dermatology, advanced dentistry and internal medicine," mentioned one expat living in Costa Rica.

"Still working on the local insurance. Today I go out of pocket. Still less expensive than US," said an expat in Costa Rica.

"Medical and dental care are easily obtained, efficient, professional and relatively inexpensive here," remarked one expat in Costa Rica.

"We currently don't have healthcare insurance in Costa Rica, so we pay out of pocket for doctors and prescriptions. It is less than we were paying for deductibles in the United States. I have Medicare/Medicaid and would fly home for treatment, if needbe. However, we have applied for residency in C.R. and will be fully covered once we're approved," said one expat living in Costa Rica.

"Residency to obtain public health care (CAJA) seems to be taking about 18 months, so you will have to use private care until you obtain residency (if that is what you plan on doing). Even with CAJA, many people continue to use the outstanding private facilities available in and around San Jose (possibly in other areas, but I am only familiar with San Jose). There are many expat health insurance plans available and I highly recommend obtaining one if you are under 70. There may be some available over 70; I don't know. I presently do not have any insurance and have been paying out of pocket for some serious medical issues. I suggest you have a fund of $6-10,000 tucked away if you don't have private insurance or have a high deductible," commented one expat living in Grecia, Costa Rica.

"National health care may not provide a sufficient safety net - it may require a long wait for medical procedures. Private health care is recommended, but coverage for "pre-existing conditions" is generally not available except through national health care," mentioned one expat living in Costa Rica.

"Costa Rica has excellent medical care with a two prong system, both public and private. All legal residents and citizens of Costa Rica are eligible to participate in the public healthcare system which is basically free although you have to be a member of the CAJA and pay a % based on the income level you declared when you applied for residency. A tip for expats is to show evidence of enough income to qualify for their residency programs but perhaps not to show all your income if not needed to qualify. (You have to show proof of a pension, annuity or government program that pays you at least $1000 per couple to qualify for their pensionado program). If you don't qualify by those means, you can also apply as a rentista, (renter), an inversionista (an investor) or as a foreign sponsored national with a work visa. You can also marry a Costa Rican... Keep in mind that there is also a private healthcare network available, which is often the preferred option to many expats. There is often a waiting time to get seen under the public system, even things like lab work might take longer than you want to wait. The private healthcare system is generally available immediately and insurance can be purchased to cover you in those facilities. You can also often offer to pay at the CAJA and be seen quicker than those not paying for service. In an emegency, the CAJA will take anyone. Costa Rica uses a local clinic methodology where they locate clinics nearly everywhere based on population needs. These clinics are referred to as the EBAIS clinics and can be found in nearly every town of any size. Major operations, whether in the public or private healthcare system, will likely be performed in San Jose. The private healthcare networks consisting of Clinica Biblica, CIMA and Hospital Mexico, offer great service for a fraction of the cost in the US. Clinica Biblica has an international medicine center, assigns patients a health navigator to help with things like language barriers and offers services that may not even be available in the states. I have had nothing but great experiences there, everything from blood work, orthapedics, dentistry, colonoscopy, endoscopy, stress test and EKG, bone density scans, lipids exams, urinalysis, hearing and eye tests, ultrasounds and more. I have stuff done that I could never afford to do in the states and pay a fraction of the cost I would in the US. The facilities are all impeccably clean and the doctors don't seem to be afraid of their patients and lawsuits. In our area in the southern Pacific region of Costa Rica, we have one of the newest CAJA hospitals in all of Costa Rica. The Hospital de Osa is an 88 bed, 80,000 square foot facility complete with emergency room, pharmacy and more. I recommend everyone should try the Costa Rican healthcare system to see what we are missing in the US," said an expat in Costa Rica.

"If you're a resident you pretty much have to enroll in the Caja, the public health system, and if you aren't, you can't. So there's that. Whether or not you enroll in the Caja, if you have the funds, private insurance is nice. INS, the state insurance company, sells a pretty good policy for not too much money, and (ahem) it's darn near customary not to mention pre-existing conditions on the application. After a year or so INS doesn't care, and it does pay. Blue Cross and others have now entered the market, but I doubt they're as lax as INS. Of course, you can always pay out-of-pocket for private at prices about a third of US prices, but even a third adds up. Me, I'm only in the Caja now, since I let my INS policy lapse, but that's because I'm poor. People of some affluence usually do both--private for ease and comfort, public as a backup. Oh, in the Caja plan on speaking Spanish. Most Caja docs will know a little English and a few will be fluent, but the system operates in Spanish and you can't count on anyone speaking English. In the private system almost everybody speaks English," remarked one expat in Costa Rica.

"In Costa Rica, you must be a resident of the country to qualify for CAJA also know as the national socialized medicine. Additionally, this is not an option but a requirement of your residency here. The monthly fee is calculated based on your income. The local clinic also known as EBAIS is centrally located. If you are in the area, familiarize yourself with it's location. If you are not a resident, there are several private care physicians in the area and they are well educated and professional. If you do not speak Spanish, there are many that are bilingual. I know of at least one that has a 24 hour facility for emergencies. Additionally, specialists from the Central Valley visit these private care facilities on a monthly basis so if you need specialized care, it is available. At present, a general office visit in a private care facility is $40-$45," said one expat living in Costa Rica.

"To use the socialized medical system in the area, you do not need to be a resident of Costa Rica (Residente). The hospital will accept all patients. It is not a large hospital and some procedures will be referred to either the closest national care hospital or one of the private hospitals in the Central Valley. However, there are many private care physicians in the area who will treat you and/or make referrals to more specialized care in other parts of the country. The local hospital has an emergency center," commented one expat who moved to Costa Rica.

"My recommendation is to enroll in the public health system, but it is also VERY IMPORTANT to have private health insurance, since that would avoid worries about the immediate availability of the services that are required," said one expat.

"Costa Rica has a comprehensive healthcare system that provides a wide range of services to its citizens and foreign residents. The public healthcare system is funded by the government and is available to all citizens and legal residents. The quality of public healthcare is generally good, with modern facilities and well-trained staff. Foreign residents have access to the public healthcare system, although they may need to pay a fee for some services. Expats in Costa Rica can use the public healthcare system, but they may need to pay a fee for some services. Expats can also opt for private healthcare, which is more expensive but offers more comprehensive coverage," commented one member living in Costa Rica.