15 Expats Talk about Health Insurance and Healthcare in 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," said an expat in Tamarindo.

"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 living in Cortez, 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," 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," remarked one expat living in Florencia.

"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," said one expat living in Costa Rica.

"Healthcare in Costa Rica is generally considered to be of a high quality and is relatively affordable compared to other countries. Health insurance is also available in Costa Rica, but it is not mandatory. The cost of health insurance depends on the type of coverage and the provider, but it is generally more affordable than in other countries," remarked one expat living in Costa Rica.

"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," said one expat living in Playa Jaco.

"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," mentioned one expat in San José.

"I'm about 2 miles from my assigned public hospital, Calderon Guardia, and roughly the same distance from two private hospitals, Catholica and Clinica Biblica. For an emergency I would go (and have gone) to the public hospital. It has everything 24/7, and there's no payment expected for admission to the ER. The private hospitals don't necessarily have the right specialists on site and sometimes want cash (in the thousands of dollars) up front to be admitted, even in an emergency. I knew someone who died from a heart attack, probably because she went to a private hospital first and didn't have $20,000 cash on her. At the public hospital, the quality of care is ultimately good on what counts--the docs save lives and patch people up--but it's a real zoo. Patients, maybe you, line the halls since ward space is limited, and yes wards are as good as it gets. Don't expect semi-private rooms, much less TVs, telephones, or internet access. It's like a MASH hospital, just larger, but if you need the ER, it will take care of you. You'll just be glad to get out as soon as you can, and vow to go private if it's not a real emergency," remarked one expat in San José.

"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," remarked one expat living in Grecia.

"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," said one expat living in Santa Ana.

"We are located almost across the highway from the Hospital de Osa in Cortez. It is a public hospital, 80,000 square feet and offers everything we need for the entire region," mentioned one expat in Cortez.

"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," commented one expat who moved to Playa Jaco, Costa Rica.

"Drive 1 hr 30 minutes to see specialists in Liberia. Some medical procedures, such as an MRI, require a drive to San Jose, 5 hours away," mentioned one expat in Tamarindo.

"If you are enrolled in the CAJA (socialized medicine), prescriptions are free at the local clinic after being prescribed by the CAJA physician. Sometimes generic forms of the medicine are available. If you are on a very specialized prescription, you may need to purchase this at a local pharmacy (farmacia) and you would be required to incur the expense but generally most medicine is available thru the CAJA. If you choose to purchase your prescriptions outside of the CAJA system, there are at least ten farmacias in Jaco and the surrounding area. You will not need a prescription for most any medicine with the exception of intense narcotics. If you need something of that degree, a private care physician can prescribe them for you. Some prescriptions are higher costing than the US such as Allegra, simple asprin, etc. Generally speaking if you can purchase it stateside in a bottle of (for example) 365 pills it is less expensive to do so as packaging here is by individual blister pack pills. Other meds are dramatically less expensive than the states. Resident discounts are generally offered in the amount of 10% at farmacias for local residents," remarked one expat in Playa Jaco.

"Medicines prescribed in the public sector are received at your care center, at no cost to the patient. In that sense, the availability of drugs is always high. I do not need prescription drugs. If you have to buy a drug and pay for it yourself, the cost is high in the country," remarked one expat living in Santa Ana.

"The public system dispenses generic medicines free, and getting them is easy. But on the advice of a private doc, I pay retail for a name brand pill too. It costs me about a third or less the cost in the US. No prescriptions are necessary for most meds, and even when they are, you can sometimes sweet talk your way into buying them in a drug store without a prescription. Probably the cheapest drug store is La Bomba, and it won't budge on selling meds it's not supposed to, but most meds that require a prescription in the US don't need one here. For meds that the drug stores really aren't supposed to sell without prescriptions, I go to a more full service drug store and pay a little more. Specifically, I keep a supply of antibiotics on hand that by law need a prescription but I buy without one. Also, just in the way the system works, I know a drug store that sells the morning after pill, even though it's really not suppose to in a Catholic country," said one expat living in San José.

"For most meds, you can simply see the pharmacist. I get most of my refills by simply asking for them. They are not expensive but they are not cheap -- one b.p. drug I take cost about $1/pill; another drug is $2/pill. When I came here, I had been on two narcotic pain meds for 13 years. It was impossible to find Vicodin in Costa Rica and very difficult to regularly find MS contin (and then only as an injection). My doc switched me to Oxycontin which I hated, so I decided to detox and get off the pain meds -- because I am no longer working, I find that I can handle my chronic pain issues with other drugs and yoga. But be forewarned about narcotic meds if you feel you need them here," mentioned one expat in Grecia.

"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," said an expat in Ojochal.

"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," commented one expat living in Costa Rica.

"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," wrote one expat.

"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," commented one expat who moved to San Jose.

"You will not be covered by the socialized health system until you have gained Temporary Residency which is presently taking over a year. Then, you will have to pay at least $220 per month for healthcare, even if you don't use it. Most expats chose to purchase additional insurance," 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," wrote an 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 an expat in Costa Rica.