While Costa Rica becomes a popular place for expats to call home, understanding the healthcare delivery system is important. Quite different from North America and parts of Europe, Costa Rica’s healthcare system has different options to suit 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:
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 (pronounced cah-hah) is a national healthcare service provided by (Caja Costarricense de Seguridad Social, or CCSS and funded by individual premiums and some taxes. This is available to all Costa Rica citizens and legal residents who pay a monthly premium based on 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 note that enrollment in the Caja is obligatory for those who apply for and receive 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. Though all-inclusive, the Caja comes up a bit short in the area of rights and privileges you may have come to expect from the healthcare system in your country of origin. 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. Because the system is available to all residents and citizens, it stays busy with appointments for certain tests, specialist visits, or surgeries set 2 to 3 years in the future. Because of this, many expats use the Caja only for routine visits, prescription medications and emergency situations.
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 range from $100 per month (for a healthy young person or for catastrophic care only) to $1000 per month with comprehensive benefits and 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 internationally and in the US, giving you the option to travel home for a procedure and without obtaining additional 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 reasonably healthy persons who may or may not maintain healthcare coverage in their country of origin. 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 be treated until a security deposit is secured, by cash or a credit card, and could range anywhere from a few hundred to a few thousand dollars. You pay later once the expense is tallied and you are discharged.
As you can see, there are many options for good quality healthcare in Costa Rica. From public to private, Costa Rica’s healthcare professionals are highly trained and deliver care that is second to none. With options to access care available, you’re in good hands in Costa Rica.