How are healthcare services in Costa Rica?

"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," explained one expat living in Grecia, 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," said another in San José, Costa Rica.

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