15 Expats Talk about Health Insurance and Healthcare in Costa Rica

"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 one expat who moved to San José.

"In Costa Rica, you must be a resident of the country to qualify for CAJA also know as the national socialized medicine. Additionally, this is not an option but a requirement of your residency here. The monthly fee is calculated based on your income. The local clinic also known as EBAIS is centrally located. If you are in the area, familiarize yourself with it's location. If you are not a resident, there are several private care physicians in the area and they are well educated and professional. If you do not speak Spanish, there are many that are bilingual. I know of at least one that has a 24 hour facility for emergencies. Additionally, specialists from the Central Valley visit these private care facilities on a monthly basis so if you need specialized care, it is available. At present, a general office visit in a private care facility is $40-$45," said one expat.

"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," remarked one expat 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," remarked one expat living in Florencia.

"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 an expat 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," commented one expat living in Cortez, Costa Rica.

"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," wrote one expat.

"Emergency services in Costa Rica are generally reliable and efficient. In the event of an emergency, you can call 911 to request an ambulance. The emergency services personnel are trained to respond quickly and provide medical assistance. Additionally, the Costa Rican Red Cross provides emergency medical services and can be contacted by dialing 128," said one expat.

"We are located almost across the highway from the Hospital de Osa in Cortez. It is a public hospital, 80,000 square feet and offers everything we need for the entire region," remarked one expat in Cortez.

"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," remarked one expat living in Grecia.

"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 expat living 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," mentioned one expat in Santa Ana.

"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," wrote an expat living in San José.

"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)," commented one expat who moved to Tamarindo.

"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," said one expat.

"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," mentioned one expat in Ojochal.

"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," commented one expat who moved to 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," remarked one expat living in San Jose.

"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," commented one person.

"I am eligible to enroll in the public health system. To do so, the expat must have their legal residence. The amount of the voluntary insurance is about US $ 40 a month (US $ 480 a year), and the registration process is simple. Generally, expats insure themselves, since it is an advantage to have a fairly wide network of public hospitals. Pre-existing conditions are covered. The quality of the public health service is debatable, as the times to get medical appointments are sometimes very long," wrote an expat living in Santa Ana.

"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," remarked one expat 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 expat living in Florencia.