Healthcare and Health Insurance for Expats Moving to Costa Rica
Anyone moving abroad should understand the medical landscape before making the move. Having a plan in place for meeting your primary care, emergency care, elective care, and medication procurement can give you peace of mind and ensure that you and your loved ones are taken care of in any event.
The StartAbroad Costa Rica Guide
Healthcare and health insurance for expats moving to Costa Rica
Healthcare in Costa Rica
Healthcare overview for expats in Costa Rica
Costa Rica has the 33rd best healthcare system in the world, and one of the best in Latin America.
There are three types of medical facilities you can access in Costa Rica. Hospitals stay open 24/7, and provide all of the services you would expect from a U.S. or Canadian hospital. Clinics have operating hours from 7 in the morning to around 9 or 10 at night. Ébais are more community-based, and are good locations to get treatments for minor issues.
The universal, public healthcare system is called the CAJA (Caja Costarricense de Salud Social), and is available for all residents. Once you become a Costa Rican resident, you are obliged to pay into the "social security" system that supports the CAJA. This is calculated as a percent of your monthly income. For most expats, your monthly fee will be based on the financial amount you declared on your residency application. Note that CAJA fees increased in March 2022, and may now be as high as 13-18% depending on your route to residency.
Expat Health Insurance in Costa Rica
Once you are a resident, leveraging CAJA and/or INS services can cover your medical needs in the country. Before getting residency AND if you want care outside of Costa Rica, you may want to consider an international plan.
You may choose to purchase a plan from an international provider targeting expats like GeoBlue, Cigna Global, or Allianz International. These are typically worthwhile if you want to use your plan in multiple countries. Note that you can include or exclude U.S. coverage in these plans and including the U.S. will lead to much higher premiums (Canada is typically easily included for no additional cost).
Depending on your situation, you may want to ensure that your insurance covers an evacuation flight to the U.S. if you may require specific emergency treatment.
Access to healthcare for expats in Costa Rica
CAJA covers primary care needs, medications, emergency care, and most surgeries. It offers great preventative care (including blood panels, colonoscopies, normal health check-up), and strong emergency care services.
However, wait times for those with CAJA insurance only can be lengthy (sometimes years for elective surgeries), some services are not available, and the list of available medications is not comprehensive.
You can get additional private coverage from the INS (Instituto Nacional de Seguros), the government's insurance provider, or a number of local insurance companies. INS is the largest and oldest provider, and used to have a monopoly on private insurance. Rates vary, but you can expect to pay roughly $50-250 per month for 70% coverage of exams, visits, drugs, and hospitalizations plus 100% of surgeries and anesthesia. With INS you can select your own doctors and use private hospitals and clinics. Note that you cannot apply for INS after age 75.
Middle to upper class Ticos and foreigners tend to use both INS and CAJA. For those used to U.S. healthcare, the CAJA system can seem impersonal. If having a strong relationship with a primary care physician is important to you, we recommend using private health services.
If you use CAJA and INS, care is often received on a first-come, first-serve basis, even if you have made an appointment. You should be prepared to wait before being seen by a doctor. Private insurance can help you skip those long wait times, and cover you for any medical services not covered by INS or CAJA. Private hospitals are good options for speedier care and for English-speaking doctors.
Emergency services can be reached in Costa Rica by dialing 911.
Finding a doctor
The U.S. Embassy in Costa Rica has an informational sheet to help Americans looking for medical care. Many of the doctors on their list speak English and/or have had medical training in the United States.
The Costa Rican government recommends that you look up any doctor in Costa Rica in the national registry, to ensure that they are 1) registered, and 2) registered in the appropriate category for the services they are offering. You can conduct a doctor search here.
Laws governing prescription medication are not nearly as restrictive in the U.S. You can often go directly to your local farmacia (pharmacy) to get medication.
If you become a resident in Costa Rica, we recommend blending the CAJA with another insurance plan tailored to your needs. If you will be in Costa Rica full-time, INS is likely enough. If you want coverage in multiple countries, you can consider an international plan. Including the U.S. on these plans is only advisable if you will be spending significant time in the U.S. every year. Otherwise you can always get trip insurance for shorter U.S. trips. For those with ongoing health issues or those taking expensive medications, we strongly recommend private insurance.
We also recommend engaging a local physician in your town or region on a concierge basis. This person can become your 'go-to' for any medical question or event, and can help you navigate the local healthcare environment.
Many Costa Rican policies don't cover outpatient costs. Remember that outpatient fees in Costa Rica are typically much lower than in the U.S., so an inpatient-only policy may be right for you if you have no current health issues.
Regardless of provider, always check the fine print to be sure there are no clauses that give insurers the right to cancel your policy once you reach a certain age.