Puntarenas Beach, Costa Rica

Healthcare & Health Insurance in Costa Rica

By Joshua Wood, LPC

Summary:

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What are healthcare services like in Costa Rica?

When we asked expats and global nomads about the quality of medical care in Costa Rica, they replied:

"Residency to obtain public health care (CAJA) seems to be taking about 18 months, so you will have to use private care until you obtain residency (if that is what you plan on doing). Even with CAJA, many people continue to use the outstanding private facilities available in and around San Jose (possibly in other areas, but I am only familiar with San Jose). There are many expat health insurance plans available and I highly recommend obtaining one if you are under 70. There may be some available over 70; I don't know. I presently do not have any insurance and have been paying out of pocket for some serious medical issues. I suggest you have a fund of $6-10,000 tucked away if you don't have private insurance or have a high deductible," said one digital nomad in Grecia.

"Costa Rica has excellent medical care with a two prong system, both public and private. All legal residents and citizens of Costa Rica are eligible to participate in the public healthcare system which is basically free although you have to be a member of the CAJA and pay a % based on the income level you declared when you applied for residency. A tip for expats is to show evidence of enough income to qualify for their residency programs but perhaps not to show all your income if not needed to qualify. (You have to show proof of a pension, annuity or government program that pays you at least $1000 per couple to qualify for their pensionado program). If you don't qualify by those means, you can also apply as a rentista, (renter), an inversionista (an investor) or as a foreign sponsored national with a work visa. You can also marry a Costa Rican... Keep in mind that there is also a private healthcare network available, which is often the preferred option to many expats. There is often a waiting time to get seen under the public system, even things like lab work might take longer than you want to wait. The private healthcare system is generally available immediately and insurance can be purchased to cover you in those facilities. You can also often offer to pay at the CAJA and be seen quicker than those not paying for service. In an emegency, the CAJA will take anyone. Costa Rica uses a local clinic methodology where they locate clinics nearly everywhere based on population needs. These clinics are referred to as the EBAIS clinics and can be found in nearly every town of any size. Major operations, whether in the public or private healthcare system, will likely be performed in San Jose. The private healthcare networks consisting of Clinica Biblica, CIMA and Hospital Mexico, offer great service for a fraction of the cost in the US. Clinica Biblica has an international medicine center, assigns patients a health navigator to help with things like language barriers and offers services that may not even be available in the states. I have had nothing but great experiences there, everything from blood work, orthapedics, dentistry, colonoscopy, endoscopy, stress test and EKG, bone density scans, lipids exams, urinalysis, hearing and eye tests, ultrasounds and more. I have stuff done that I could never afford to do in the states and pay a fraction of the cost I would in the US. The facilities are all impeccably clean and the doctors don't seem to be afraid of their patients and lawsuits. In our area in the southern Pacific region of Costa Rica, we have one of the newest CAJA hospitals in all of Costa Rica. The Hospital de Osa is an 88 bed, 80,000 square foot facility complete with emergency room, pharmacy and more. I recommend everyone should try the Costa Rican healthcare system to see what we are missing in the US," commented a person living in Cortez, 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," explained one digital nomad living in Tamarindo, Costa Rica.

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What is the quality of medical care in Costa Rica like?

When we asked expats and global nomads about the quality of medical care in Costa Rica, they replied:

"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," said one member 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," explained one expat in Costa Rica.

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Are healthcare and health insurance expensive in Costa Rica?

"I had private health insurance in Costa Rica for several years prior to being a member of the socialized medicine care. It was less expensive that the states. In many cases, your private health insurance will allow you the hospital of your choice," explained one person living in Playa Jaco, 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," wrote one digital nomad living in Costa Rica.

"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," said one foreigner in Santa Ana.

"Amazingly inexpensive. My personal experience with costs without insurance include a colonoscopy that was quoted at $3300 in the states that was done in Costa Rica for $300. I have a number of crowns in my mouth that I paid $300 to $400 including the root canal and crown," remarked one member in Cortez.

"Healthcare in Costa Rica is generally considered to be of a high quality and is relatively affordable compared to other countries. Health insurance is also available in Costa Rica, but it is not mandatory. The cost of health insurance depends on the type of coverage and the provider, but it is generally more affordable than in other countries," explained one expat living in Costa Rica.

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What are emergency services like in Costa Rica?

When we asked about emergency services, members in Costa Rica wrote:

"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 digital nomad in San José.

"Near me there are public primary care units that do not attend emergencies. The best private hospitals are Hospital Clínica Bíblica, CIMA and Clínica Católica. These services are of the highest quality. The availability of ambulances is good, both for the private and public areas," commented a person living in Santa Ana, Costa Rica.

"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," explained one digital nomad living in Tamarindo, Costa Rica.

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Will I need to travel to see a specialist?

"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 a person living in San José, Costa Rica.

"We have been to CIMA and Catolica. Both these facilities are excellent! The physicians were profesional, thorough and well educated. The care was better than what we experienced stateside. The physician followed up with us after our care for several weeks. And we were given private cell phone numbers to contact in case of complications. My husband spent three nights at CIMA in Escazu near San Jose. He had a private room (all rooms in this facility are private!) with attached private bathroom. There was a sofa in the room which turned into a bed so that I was able to spend the day and evenings there. The hospital cafeteria was excellent! Yes that's a surprise and gives an upscale meaning to hospital food! This is one instance where we decided to have treatment at a private facility vs. the socialized medicine. Be aware that at these facilities, you will need to submit a credit card or private health care card in order to be treated. The cost was dramatically less than if this procedure was done stateside. It is very common for residents to use the socialized medicine for some issues, private health care for others (which means you pay out of pocket) and also have another health insurance policy for others health issues," explained one digital nomad living in Playa Jaco, Costa Rica.

"I have not needed to do that so far, so I have no information except from friends, all who have been HIGHLY pleased with their specialists in San Jose," said one member in Grecia.

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Are common prescription medications available in Costa Rica?

"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 a person living in Costa Rica.

"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," explained one digital nomad living in San José, Costa Rica.

"Prescriptions are easy to get and easy to fill. Many drugs requiring a perscription in the US don't need one in Costa Rica. I have found that most drugs are 1/3 to 1/4 of the price than in the US," said one member in Cortez.

"Medicines prescribed in the public sector are received at your care center, at no cost to the patient. In that sense, the availability of drugs is always high. I do not need prescription drugs. If you have to buy a drug and pay for it yourself, the cost is high in the country," explained one expat in Santa Ana.

"Most are available locally at a nearby pharmacy. Most are available without a prescription, except narcotics. Generic "prescription" drugs are lower cost but typical OTC drugs seem to be more expensive (ibuprofen, aceotminophen)," remarked one global nomad in Tamarindo.

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Do you have anything more to add about local medical facilities in Costa Rica?

"Playa Jaco has a Red Cross station in addition to local public clinic. In the event of illness or injury, you will be treated at the local clinic and transportation to a higher level of medical care is provided. There are also many private physicians in the area which will provided specialized medical care. I have found the level of care to be excellent. The Central Valley is only 90 minutes by vehicle and this area of Costa Rica boasts the highest level of care in the country and in many cases Central America," wrote one digital nomad living in Playa Jaco, Costa Rica.

"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 foreigner in San Jose.

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As a foreigner living in Costa Rica, will I have access to public healthcare? What is it like?

"Yes, as a foreigner living in Costa Rica, you will have access to public healthcare. The public healthcare system in Costa Rica is known for its high quality of care and is considered to be one of the best in Latin America. The public healthcare system is funded by the government and is available to all citizens and legal residents of Costa Rica. The public healthcare system provides a wide range of services, including primary care, specialty care, hospital care, and preventive care. The public healthcare system also offers free or low-cost medications and treatments," said a member 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," explained one person living in Costa Rica.

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What have your experiences during the pandemic with the local healthcare system been like?

We asked expats in Costa Rica if they have access to public healthcare in Costa Rica. And, if they do have access, what is it like. They wrote...

"Mandatory masks, vaccines given to teachers, healthcare workers and the elderly. I am not hearing of anyone refusing the vaccine," said one digital nomad in Florencia.

"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 a person living in Costa Rica.

About the Author

Joshua Wood Joshua Wood, LPC is one of the Founders of Digital Nomad Exchange and serves as Co-President of Expat Exchange. Prior to Expat Exchange and Digital Nomad Exchange, Joshua worked for NBC Cable (MSNBC and CNBC Primetime). Joshua has a BA from Syracuse and a Master's in Clinical and Counseling Psychology from Fairleigh Dickinson University. Mr. Wood is also a licensed counselor and psychotherapist.

Some of Joshua's articles include Pros and Cons of Living in Portugal, 10 Best Places to Live in Ireland and Pros and Cons of Living in Uruguay. Connect with Joshua on LinkedIn.

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