Healthcare in Costa Rica for expats

Healthcare in Costa Rica for expats

CIMA Hospital has state-of-the art facilities

Costa Rica has some of the best healthcare in Latin America.  It is not often you can use the terms “high quality” and “affordable” in the same sentence when talking about healthcare!  But that is the reality in Costa Rica, where most hospitals are clean and state-of-the-art, and doctors are well-trained and attentive.

There are basically three ways to pay for healthcare in Costa Rica:

  1. Sign up for the Caja (Caja Costarricense de Seguridad Social, or CCSS). 
  2. Purchase private national or international insurance.
  3. Pay for healthcare out-of-pocket, as needed.

The Caja

The Caja (pronounced cah-hah) is a national healthcare service that is available to all Costa Rica citizens and legal residents who pay a monthly membership based on age and income.  After that, there are no deductibles or co-pays.  All doctor’s visits, tests, hospitalizations, surgeries, medications, etc., are free.

It is important to note that enrollment in the Caja is mandatory for those who apply for and receive residency.  If you are NOT planning to become a resident of Costa Rica, the Caja is not 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—everything!  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 the selection is limited.  The brand you used back home will almost certainly not be available through the Caja.  Because the system is overburdened, appointments for certain tests, specialist visits, or surgeries may be set for 2 to 3 years in the future.  Because of the foregoing, many expats use the Caja only for routine visits and emergency situations.

Hospital Mexico CCSS

Can I purchase health insurance that will cover me in Costa Rica?  Yes, this is your second option for covering your healthcare costs:  purchase private national or international health insurance.  The most common national provider is INS, and you can check their rates here.  A policy normally pays up to $200,000 annually in health care costs. National health insurance providers can be quite inexpensive until the subject of pre-existing conditions comes up.  Generally, these are not covered at all, or the company may even refuse to insure you.

International health insurance is better than local insurers in many ways.  Coverage is often up to $1 million per year, which should suffice to pay for almost any medical situation.  Complete your due diligence and find out if the clinics or hospitals near you accept your choice of insurance.

What does international health insurance cost?  There are a lot of variables that affect the premium—age, benefits, deductibles, etc.  Prices 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.

Here is a list of some popular international insurance companies.

  • Cigna Global is 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.

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 scenario, you make an appointment with a local doctor or specialist of your choice and as needed and pay for it.  Doctors’ visits run $75-85 a visit, and that price sometimes includes additional tests.  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, etc.   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 (meaning life or death), an ambulance will take you to a national or private hospital.   You may not be treated until a security deposit is secured in the form of cash or a credit card that 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, you have many options for good quality healthcare in Costa Rica.  There is no need to worry whatsoever!  Just pack your flip flops and sun hat and come on down!

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