Costa Rica Healthcare

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Overview

Costa Rica has a nationalized health care system called CAJA. All Costa Rica citizens, temporary and permanent residents. must participate in the CAJA program, no exceptions. Those here on a tourist visa are not eligible to use CAJA and must pay out of pocket using private clinics and hospitals.

For some Costa Ricans, CAJA is free. For others that have exceeded the maximum income level for free benefits, and for all temporary and permanent residents, there is a monthly fee based on net income, after expenses. On average this will equate to between $30 and $100 USD per month.

For those that prefer private healthcare, Costa Rica has ample private hospitals, clinics and pharmacies that that provide excellent services at reasonable, and often inexpensive fees.

Private insurance is available at a fraction of the cost of a policy in the United States. My worldwide coverage policy through Blue Cross Blue Shield is a little less than $200 per month. This is a catastrophic, $10,000 deductible policy. The same policy, from the same provider, quoted from an insurance company in the United States, was $3000 per month.

The big difference between Costa Rica and other countries in the world, is that they do not accept pre-existing conditions for private insurance plans. You will either be denied coverage, or provided coverage with specific exclusions. For example, a person with high cholesterol may be accepted for insurance but excluded for any cardiovascular related incident such as a heart attack and stroke.

Access

The greatest concentration of the best hospitals are located in San Jose and the surrounding suburbs.

For people living in the popular Pacific Northwest towns of Playa Flamingo, Tamarindo and Coco, the nearest major hospital is located in Liberia and ranges from 30 to 60 minutes away. While there are some small hospitals, clinics and emergency services in these areas, not all are open 24/7.

While the quality of care is excellent, getting there could be a problem if you live far away.

In Costa Rica, don't expect to dial 911 and have emergency services there within a few minutes...not going to happen. One night, We were right behind a bad accident and the ambulance didn't arrive for 45 minutes.

If you have a major medical condition, and are looking to relocate to Costa Rica, you are going to want to live very close to a major hospital, most likely in and around San Jose.

Quality and Cost of Care

In discussing with locals and others who have been here for awhile, Caja is great for prescriptions and minor ailments, but for anything major, the wait time could be long and the quality of care not as good as the Costa Rica private healthcare system.

We have used the private healthcare systems a few times and have been very impressed by the results.

Appointments could be scheduled almost immediately or certainly within a few days.
You meet with the doctor, not a physicians assistant, and will most likely spend 30-45 minutes discussing your issue.
X-rays and bone scan tests were completed and formal reports provided and discussed with the Doctor during the original appointment.
Lab work results were emailed within a few hours and followed up with the Doctor via a phone call.
A complete blood work panel costs about $150 USD
A complete body bone scan costs about $83 USD
The ability to speak English is a requirement of being a doctor in Costa Rica. Actual results may vary, but in all cases we were able to communicate in English with few issues.

Prescriptions

Most medicines cost more in Costa Rica than in the United States. However, in many cases, due to the more relaxed lifestyle, healthier food and increased exercise, you may find that you don't need that blood pressure or cholesterol medicines. Once you are able to join CAJA, all medicine is free.

Existing prescriptions from other countries can be refilled by taking the empty container to the pharmacy.

Summary

If you have major health issues, Costa Rica may not be for you unless you are willing to pay for private insurance and live close to one of the major private hospitals, mostly around San Jose and the adjacent suburbs. Live out in the country, and experience a major event, most likely you won't get help in time.

For those paying out of pocket, medicine is expensive but services are not anywhere close to the amount they charge in the United States.

Once you become an official resident, medicine and care is available through CAJA, for a nominal monthly fee, but wait times will most likely be longer than private hospitals.

You cannot qualify for CAJA until you become a temporary or permanent resident and this process takes 12-18 months before you are eligible, and only if you meet strict requirements to become a resident. See our immigration page for details.