While Costa Rica becomes a popular place for expats to call home, understanding the healthcare delivery system is important.
Costa Rica’s healthcare system is different from those in North America and parts of Europe. It offers various options for different needs.
Many of the doctors have done their specialization training abroad. Costa Rican doctors are known for their outstanding knowledge, experience, and care. Here’s what you need to know about healthcare in Costa Rica.
There are basically three avenues of obtaining healthcare in Costa Rica:
Caja
Costa Rica’s single-payer health insurance, funded by individual premiums and taxes.
Private Insurance
This includes traveler’s insurance, international insurance and Costa Rica-issued private healthcare insurance.
Out of Pocket
Pay-as-you-go, as needed.
The Caja
The Caja (pronounced cah-hah) is a national healthcare service in Costa Rica. It is run by the CCSS (Caja Costarricense de Seguridad Social) and is paid for by individual fees and some taxes.
This is open to all citizens and legal residents of Costa Rica. They must pay a monthly fee depending on their age and income.
Once in the Caja system, there are no deductibles or copays for non-elective services. All doctor’s visits, tests, surgeries, hospitalizations, medications and more are covered 100%
It is important to know that joining the Caja is required for people who ask for and get residency.
If you are NOT planning to become a resident of Costa Rica, the Caja will not be available to you.
How much does the Caja cost?
Your monthly premium is based on your age and income at the time of enrollment. You can expect to be assigned an amount that is about 4-12% of your declared income. Consult someone with experience about the ins and outs of enrollment in order to avoid overpaying.
What does Caja coverage include?
The Caja coverage is extensive. It includes walk-in and scheduled visits to the local clinic, periodic tests (blood and otherwise), vaccinations, medications, hospitalization, surgery, therapy, eyeglasses and a host of other goods and services.
The Caja includes many services, but it may not offer all the rights and benefits you expect from healthcare in your home country.
Doctors are rotated among clinics, so follow-through of your case can be lacking. Medications are provided without cost, but brand availability may be limited.
The system is open to everyone. This means it often has a lot of appointments. Some tests, specialist visits, or surgeries are scheduled for 2 to 3 years from now.
Because of this, many expats use the Caja only for routine visits, prescription medications and emergency situations.
Private Insurance
Your second option for covering your healthcare costs are private national or international health insurance.
The most common national provider is INS, and offers choices in plans and benefits. A policy through INS normally pays up to $200,000 annually in health care costs. National health insurance providers can be quite convenient with the possible exception of pre-existing conditions.
Generally, such conditions are excluded from coverage or the company may also decline to insure you.
International health insurance can prove superior to local insurers in many ways. Coverage is often up to $1 million per year (which should suffice for almost any medical situation). Complete your due diligence and find out if the clinics or hospitals near you accept your choice of insurance.
The cost of international health insurance depends on several variables that affect the premium—including age, benefits and deductibles.
Prices can vary from $100 a month for a healthy young person or for just basic care to $1000 a month for full coverage with no deductibles.
The average cost is $200-500 per month per person.
Here is a list of some popular international insurance companies.
Cigna Global and BMI are popular among expats in Costa Rica. Though not the least expensive, their plans are flexible, customizable and comprehensive and should cover everything you need. Coverage for healthcare in the US is an add-on.
GeoBlue covers US citizens both in the US and abroad. You can travel home for medical care without needing extra insurance.
IMG is a budget option and especially reasonable for young persons with no real health concerns.
Internationalinsurance.com has a list of the best plans for expats in Costa Rica.
Out of Pocket
Managing your own healthcare a la carte (or out-of-pocket) is the third option. This option is for mostly healthy people who might have health insurance from their home country or not.
It gives you the ability to control your healthcare costs and not pay premiums.
In this situation, you make an appointment with a local doctor or specialist of your choice and, as needed, pay for it.
Doctor visits run roughly $50-75 each. Visits to specialists are $100-120. If he or she prescribes further tests, you make an appointment in another clinic or lab for blood tests, an x-ray or ultrasound. The results are handed to you, and you can keep them in your own personal files or consult with your doctor.
Many medications that are prescription-only back home can be purchased over the counter at pharmacies in Costa Rica. These include blood-pressure medicines, statin drugs, diabetic needs, antidepressants, many painkillers and so on. Narcotics and antibiotics are prescription only.
In an emergency situation, an ambulance will take you to a national or private hospital.
You may not receive treatment until you pay a security deposit. Payment can be made using cash or a credit card. The amount can be from a few hundred to a few thousand dollars.
Once the total cost is calculated and you are released, you make the payment.
As you can see, there are many options for good quality healthcare in Costa Rica.
In both public and private sectors, Costa Rica’s healthcare workers are well-trained and provide excellent care.
In Costa Rica, you have many choices for good healthcare. The country has a strong healthcare system for both locals and visitors. You can find many services and facilities to meet different medical needs.
Whether you need check-ups, special treatments, or emergency care, there are many trusted clinics and hospitals. Skilled professionals work in these places to provide great care. Taking care of health is important in Costa Rica’s culture, making it a safe place for anyone needing medical help.
