Tamarindo, 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:

"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," said one digital nomad in Cortez.

"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," commented a person living in San José, Costa Rica.

"Costa Rica has a comprehensive healthcare system that provides a wide range of services to its citizens and foreign residents. The public healthcare system is funded by the government and is available to all citizens and legal residents. The quality of public healthcare is generally good, with modern facilities and well-trained staff. Foreign residents have access to the public healthcare system, although they may need to pay a fee for some services. Expats in Costa Rica can use the public healthcare system, but they may need to pay a fee for some services. Expats can also opt for private healthcare, which is more expensive but offers more comprehensive coverage," explained one digital nomad living in Costa Rica.

"My recommendation is to enroll in the public health system, but it is also VERY IMPORTANT to have private health insurance, since that would avoid worries about the immediate availability of the services that are required," said one member in Santa Ana.

"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 expat in Tamarindo.

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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:

"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," said a member in Costa Rica.

"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," explained one person living in Florencia, Costa Rica.

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Are healthcare and health insurance expensive in 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," said a member in Costa Rica.

"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," explained one person living in San José, 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:

"There is a CAJA (public hospital) in our town Grecia which is about a 20 minute drive from my house. I have not heard anything good about it. I have heard good things about the public hospital (Hospital Mexico) in San Jose and the private hospitals in San Jose (about 45 minutes from us) are all excellent," said one member in Grecia.

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Will I need to travel to see a specialist?

"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," explained one expat living in Grecia, 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," said one digital nomad in San José.

"Drive 1 hr 30 minutes to see specialists in Liberia. Some medical procedures, such as an MRI, require a drive to San Jose, 5 hours away," commented a person living in Tamarindo, Costa Rica.

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Are common prescription medications available in Costa Rica?

"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," said one member in Santa Ana.

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

"Costa Rica is considered to have very good medical care. Medical facilities are well-equipped, with many hospitals and clinics offering advanced medical technology and treatments. The country has attracted a number of foreign patients in recent years, particularly those looking for affordable medical services in a warm, welcoming environment. Costa Rica is also home to many highly trained, experienced medical professionals and the government is invested in providing quality health care for all its citizens. As a result, Costa Ricans enjoy and depend on access to excellent medical services," explained one expat living in Costa Rica.

"The Hospital de Osa, a new hospital with 88 beds, 80,000 square feet, an emergency room and lots of doctors is located just 15 minutes down the coastal highway. There are also local clinics and dentists in Uvita, the next town to the north. You won't have open heart surgery in this area, but almost anything else is possible," said one digital nomad in Ojochal.

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

"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," said one member in Costa Rica.

"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," explained one expat 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...

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

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

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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