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," wrote 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," commented one expat who moved to San José.

"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," said one expat.

"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," remarked one expat in Santa Ana.

"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," remarked one expat living in Playa Jaco.

"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 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," remarked one expat living in Costa Rica.

"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.

"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," remarked one expat 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," wrote 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," commented one expat who moved to Tamarindo.

"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," said one expat.

"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 in Playa Jaco.

"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.

"If you go private (and either pay through insurance or out of pocket), specialists are easy. They're everywhere and fast, friendly appointments are normal. If you're in the public system, specialists are often where the system breaks down the most. Everybody is assigned to a local clinic, and these are fine, but most local clinics don't have specialists. To see a specialist you're sent elsewhere, and this can take multiple visits simply to make an appointment (you actually need appointments to make appointments) and then when you finally get an appointment, it can be up to a year later. I've also had the clerk lose my file and tell me I needed to start all over again, although in fairness I once saw a specialist on the same day I was sent. Anyway, seeing specialists is often the weakest link in the public health system chain, and many locals just pay private at this point. But sometimes seeing a specialist in the public system is easy. It's a crap shoot," mentioned one expat in San José.

"Yes, common prescription medications are available in Costa Rica. Most pharmacies in the country carry a wide variety of medications, including those that require a prescription. However, it is important to note that some medications may not be available in Costa Rica, so it is best to check with a local pharmacist before traveling. Additionally, some medications may require a doctor's prescription in order to be purchased in Costa Rica," commented one expat living in Costa Rica.

"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," 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," said one expat living in San Jose.

"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," mentioned one expat in Costa Rica.

"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," wrote an expat living in Costa Rica.

"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," 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 one expat.