Expats Talk about Health Insurance and Healthcare in San Jose, 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," said one expat living in San José.

"San Jose offers a wide range of healthcare services, including both public and private hospitals and clinics. The public healthcare system is managed by the Costa Rican Social Security Fund (CCSS), which provides free or low-cost medical care to all citizens and legal residents. Private healthcare facilities are also available, offering a higher level of service and more specialized care. In addition, there are a number of specialized medical centers, such as the Costa Rican Institute of Neurology and Neurosurgery, which provide specialized care for neurological conditions. San Jose also has a number of pharmacies, providing access to medications and other health-related products," mentioned one expat in San Jose.

"San Jose offers a wide range of medical services for both locals and visitors. The country has a well-developed public health system, with a network of hospitals and clinics providing quality care. Private medical facilities are also available, offering a range of services from general practice to specialized care. Many of these facilities are equipped with the latest technology and staffed by highly trained professionals. In addition, there are a number of pharmacies and medical supply stores throughout the city, providing access to medications and other medical supplies," remarked one expat in San Jose.

"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," said one expat living in San José.

"Healthcare and health insurance in San Jose can be expensive, depending on the type of coverage and services needed. Private health insurance plans are available, but they can be costly and may not cover all medical expenses. Public health insurance is also available, but it may not cover all medical expenses either. In general, healthcare costs in San Jose, Costa Rica are higher than in other parts of the country, so it is important to research and compare different plans before making a decision," mentioned one expat in San Jose.

"Emergency services in San Jose are provided by the Cruz Roja Costarricense (Red Cross of Costa Rica). They provide medical assistance, firefighting, and rescue services. To call for an ambulance, you can dial 911 or the Cruz Roja's emergency number, 128. The Cruz Roja also has a mobile app that can be used to request an ambulance," said an expat in San Jose.

"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," commented one expat living in San José, Costa Rica.

"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," commented one expat living in San José, Costa Rica.

"Yes, there are a good number of medical specialists in San Jose. People in need of highly specialized medical care can go to the CIMA Hospital, which is a private hospital that offers a wide range of medical services, including specialized care. Additionally, the Hospital Mexico, which is a public hospital, also offers specialized medical care. For those seeking specialized care outside of San Jose, the Clinica Biblica in San Jose is a private hospital that offers a wide range of medical services, including highly specialized care," wrote one expat.

"Yes, common prescription medications are available in San Jose. Most pharmacies in the city carry a wide variety of medications, including those for common ailments such as colds, allergies, and headaches. Many pharmacies also carry medications for more serious conditions, such as diabetes, high blood pressure, and heart disease. In addition, some pharmacies offer specialized medications for specific conditions, such as cancer or HIV/AIDS. It is important to note that some medications may require a prescription from a doctor in Costa Rica, so it is best to check with the pharmacy before purchasing," wrote one expat.

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

"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," wrote one expat.

"Medical care in San Jose is generally of a high standard. The country has a well-developed healthcare system, with a number of public and private hospitals and clinics located throughout the city. The public hospitals are generally well-equipped and staffed with experienced medical professionals. Private hospitals and clinics offer a more personalized service and often have shorter waiting times. In addition, there are a number of specialized medical centers in San Jose, offering specialized treatments and services. Overall, medical care in San Jose is of a high quality and is accessible to all," commented one expat who moved to San Jose.

"Yes, as a foreigner living in San Jose, you will have access to public healthcare. The public healthcare system in Costa Rica is considered to be one of the best in Latin America, and is free for all citizens and legal residents. The public healthcare system is well-funded and provides a wide range of services, including primary care, specialty care, and hospital care. The quality of care is generally good, and the wait times for appointments are usually reasonable," said an expat in San Jose.

"Although the authorities kept warning that the healthcare system might collapse because of the pandemic, they seemed oblivious to the fact that it had already collapsed for many things and many people. I went 10 months trying to get the telemedicine appointment that supposedly replaced my canceled in person appointment, and went as long without canceled lab tests or prescription medicines. True, the system was still attending to urgent medical problems, and in fairness it was dealing with a pandemic, but a lot of us were on our own," mentioned one expat in San Jose.

"The pandemic has had a significant impact on the local healthcare system in San Jose. The healthcare system has had to adapt to the changing needs of the population, including the need for more intensive care and the need to provide care to those who are unable to access it due to the restrictions imposed by the pandemic. The healthcare system has also had to adjust to the increased demand for services, including the need for more medical personnel and the need to provide more resources to those in need. Despite the challenges, the healthcare system in San Jose has been able to provide quality care to those in need, and has been able to respond to the changing needs of the population," commented one expat who moved to San Jose, Costa Rica.