15 Expats Talk about Health Insurance and Healthcare 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.

"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," wrote one expat.

"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," commented one expat who moved to Cortez.

"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," said one expat.

"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 San José.

"Costa Rica offers a wide range of medical services, including both public and private healthcare. The public healthcare system is free for all citizens and legal residents, and is generally of a high quality. Private healthcare is also available, and is often more modern and efficient than the public system. Costa Rica is home to a number of world-class hospitals and clinics, offering a range of treatments and services. Many of these facilities are staffed by highly trained and experienced medical professionals, and offer the latest in medical technology. Costa Rica is also home to a number of specialized medical centers, offering treatments for specific conditions such as cancer, heart disease, and neurological disorders," wrote one expat.

"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 who moved to Florencia.

"The cost of medical care is high. I have private health insurance, which allows me immediate and unrestricted access to private hospitals under the conditions that I like to have at my disposal. That guarantees me care without waiting for weeks or months, compared to public health. My private insurance is accepted in all clinics in the country, and I got it on the recommendation of an expat friend," wrote one expat.

"I had private health insurance in Costa Rica for several years prior to being a member of the socialized medicine care. It was less expensive that the states. In many cases, your private health insurance will allow you the hospital of your choice," commented one expat who moved to Playa Jaco.

"Ditto here. Most docs (and dentists) speak great English and have been superb, & very inexpensive at least in Escazu (Hospital CIMA). Many have been trained in the US or the UK, plus the medical & dental school here are top of the line. Educational achievement (and speaking English) is a high priority to Costa Ricans. We dropped our CIGNA Global insurance learning this," said one expat.

"I was paying around $100 a month for my INS policy, but crossed into the next age bracket plus filed a few claims and my premium doubled. It was still a good deal, but too much for me. The Caja tax is around $100 a month for a pensionado, unfortunately much higher for rentistas. It's set by your income, and most expats just pay according to the income requirements of their residency type. Caja services, including generic prescription meds, are 100% covered, so you never pay more than your monthly tax. Private docs are realistically $80 a visit. You hear of lower prices, but if you go to a specialist (including an internist) plan on $80. As a rule of thumb, pretty much everything else is around 1/3 the price it is in the US," remarked one expat in San José.

"Amazingly inexpensive. My personal experience with costs without insurance include a colonoscopy that was quoted at $3300 in the states that was done in Costa Rica for $300. I have a number of crowns in my mouth that I paid $300 to $400 including the root canal and crown," remarked one expat living in Cortez.

"There is a CAJA (public hospital) in our town Grecia which is about a 20 minute drive from my house. I have not heard anything good about it. I have heard good things about the public hospital (Hospital Mexico) in San Jose and the private hospitals in San Jose (about 45 minutes from us) are all excellent," said one expat.

"45 minutes to a private hospital, 1 hr 30 minutes to a public hospital. Local ambulances provide local emergency care although severe medical issues may require 45 minutes or more to a hospital," remarked one expat in Tamarindo.

"The closest is EBAIS Jaco and this is one of the offices in the socialized medicine of CR. There is an emergency room, lab facility and pharmacy at this location along with general medicine physicians. The emergency room service is generally very quick! If your condition warrants more specialized care, you will be stabilized and transported to Puntarenas Hospital known as Monsenor Sanabria. This higher level of hospital care is one hour from Jaco. For private care, the 24 hour facility will assess your condition and either treat you at their facility or transport you to the hospital of your choice in San Jose in the Cental Valley. This is approximately 90 minutes from San Jose. Private hospitals in San Jose are CIMA, Biblica, Catolica, Metropolitan," remarked one expat living in Playa Jaco.

"Emergency services in Costa Rica are generally reliable and efficient. In the event of an emergency, you can call 911 to request an ambulance. The emergency services personnel are trained to respond quickly and provide medical assistance. Additionally, the Costa Rican Red Cross provides emergency medical services and can be contacted by dialing 128," said one expat living in Costa Rica.

"Near me there are public primary care units that do not attend emergencies. The best private hospitals are Hospital Clínica Bíblica, CIMA and Clínica Católica. These services are of the highest quality. The availability of ambulances is good, both for the private and public areas," mentioned one expat in Santa Ana.

"We have been to CIMA and Catolica. Both these facilities are excellent! The physicians were profesional, thorough and well educated. The care was better than what we experienced stateside. The physician followed up with us after our care for several weeks. And we were given private cell phone numbers to contact in case of complications. My husband spent three nights at CIMA in Escazu near San Jose. He had a private room (all rooms in this facility are private!) with attached private bathroom. There was a sofa in the room which turned into a bed so that I was able to spend the day and evenings there. The hospital cafeteria was excellent! Yes that's a surprise and gives an upscale meaning to hospital food! This is one instance where we decided to have treatment at a private facility vs. the socialized medicine. Be aware that at these facilities, you will need to submit a credit card or private health care card in order to be treated. The cost was dramatically less than if this procedure was done stateside. It is very common for residents to use the socialized medicine for some issues, private health care for others (which means you pay out of pocket) and also have another health insurance policy for others health issues," mentioned one expat in Playa Jaco.

"I have not needed to do that so far, so I have no information except from friends, all who have been HIGHLY pleased with their specialists in San Jose," commented one expat who moved to Grecia, Costa Rica.

"Most are available locally at a nearby pharmacy. Most are available without a prescription, except narcotics. Generic "prescription" drugs are lower cost but typical OTC drugs seem to be more expensive (ibuprofen, aceotminophen)," commented one expat living in Tamarindo, Costa Rica.

"Prescriptions are easy to get and easy to fill. Many drugs requiring a perscription in the US don't need one in Costa Rica. I have found that most drugs are 1/3 to 1/4 of the price than in the US," wrote one expat.

"Costa Rica is considered to have very good medical care. Medical facilities are well-equipped, with many hospitals and clinics offering advanced medical technology and treatments. The country has attracted a number of foreign patients in recent years, particularly those looking for affordable medical services in a warm, welcoming environment. Costa Rica is also home to many highly trained, experienced medical professionals and the government is invested in providing quality health care for all its citizens. As a result, Costa Ricans enjoy and depend on access to excellent medical services," said one expat.

"The Hospital de Osa, a new hospital with 88 beds, 80,000 square feet, an emergency room and lots of doctors is located just 15 minutes down the coastal highway. There are also local clinics and dentists in Uvita, the next town to the north. You won't have open heart surgery in this area, but almost anything else is possible," remarked one expat in Ojochal.

"Playa Jaco has a Red Cross station in addition to local public clinic. In the event of illness or injury, you will be treated at the local clinic and transportation to a higher level of medical care is provided. There are also many private physicians in the area which will provided specialized medical care. I have found the level of care to be excellent. The Central Valley is only 90 minutes by vehicle and this area of Costa Rica boasts the highest level of care in the country and in many cases Central America," remarked one expat living in Playa Jaco.

"I'm about two miles from both a public and a private hospital, but for emergencies you definitely want to go to a public hospital. The private hospitals don't necessarily have the staff onsite and want to be paid upfront. The ER room at the public hospital is a zoo (no one likes it) but once you convince the intake person that you're really sick the care is as good as anywhere in the world, just without the creature comforts. Convincing the intake personnel that you're really sick though can be a challenge. They're surrounded by people with the sniffles who really shouldn't be there. It helps to arrive by ambulance or to be bleeding or at least to have a heart attack," said one expat living in San Jose.

"Yes, as a foreigner living in Costa Rica, you will have access to public healthcare. The public healthcare system in Costa Rica is known for its high quality of care and is considered to be one of the best in Latin America. The public healthcare system is funded by the government and is available to all citizens and legal residents of Costa Rica. The public healthcare system provides a wide range of services, including primary care, specialty care, hospital care, and preventive care. The public healthcare system also offers free or low-cost medications and treatments," commented one expat living in Costa Rica.

"Mandatory masks, vaccines given to teachers, healthcare workers and the elderly. I am not hearing of anyone refusing the vaccine," remarked one expat living in Florencia.

"My experiences with the local healthcare system in Costa Rica during the pandemic have been generally positive. The government has taken proactive steps to ensure that the healthcare system is well-equipped to handle the influx of patients, including increasing the number of hospital beds and providing additional resources to medical personnel. The government has also implemented strict safety protocols to protect both patients and healthcare workers, such as mandatory mask-wearing and social distancing. Additionally, the government has provided free testing and treatment for those who are infected with the virus. Overall, I am impressed with the way the Costa Rican government has handled the pandemic and the level of care they have provided to their citizens," said one expat living in Costa Rica.