Costa Rica Healthcare System
The healthcare system in Costa Rica is frequently cited as one of the best in the world. The country is ranked 36th in the world by the World Health Organization, above the United States, Cuba, and New Zealand. Meanwhile, the United Nations ranks Costa Rica’s healthcare among the top 20 in the world. Expats frequently cite it as a major factor in their decision to relocate.
Retirees, in particular, appreciate the comprehensive, affordable care and strong public health programming. Costa Ricans are some of the healthiest people in the world, with an impressive life expectancy to show for it. This is thanks in no small part to the country’s national healthcare system.
Universal healthcare and social security have been a part of Costa Rican society since the 1940s. Universal care is provided through the CAJA system (Caja Costarricense de Seguro Social). Through CAJA, the country’s citizens and permanent residents have 100% coverage for all medical procedures, appointments, hospital visits, and prescription drugs. The system is funded by small monthly contributions from all residents, based on income levels.
As with many countries with universal healthcare, there are complaints about long waiting times and bureaucratic red tape. However, the government is continually reinvesting in the healthcare system infrastructure and hospitals, and equipment is constantly being upgraded.
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Costs of Healthcare in Costa Rica
Healthcare costs in Costa Rica are very reasonable, especially compared to other countries. Medical visits, tests, and even complex surgeries are ¼ to ⅓ as expensive in the United States.
This is a major factor driving the popularity of medical tourism in Costa Rica. Patients can have major dental work or knee replacement surgery, as well as a vacation, follow-up care, and international flights, for a fraction of the cost elsewhere.
For those who are uninsured or using private facilities, the average cost of a doctor’s visit in the country ranges from $60 to $75, while specialist care visits are closer to $100.
Many diagnostic tests, such as ultrasounds, x-rays, and blood work, are under $100. However, all these small costs can quickly add up, especially when most medical facilities require upfront payment in cash.
All costs are covered for those enrolled in the CAJA system. Patients do not have to pay anything for their appointments.
Differences Between Private and Public Care
In Costa Rica, the public and private healthcare systems work well together. For instance, many Costa Rican doctors work in the mornings for CAJA and have their own private clinic office hours in the afternoons and evenings.
Many expats embrace this mix of public and private. Many will see their local CAJA physician for their regular appointments.
However, if diagnostic testing in the public system has too long a wait, they’ll use private facilities and have the results forwarded.
By contrast, physicians in private facilities are happy to write prescriptions for CAJA pharmacies so patients can pick up medications at no cost.
While most expats hold private global medical insurance, some opt to take out a policy from the Costa Rican government’s private insurance monopoly.
This is known as the Instituto de Seguro Nacional (INS). INS policies are available to legal residents, and the INS system is affiliated with doctors, hospitals, labs, and pharmacies in the private sector.
Bridging the gap between private and public healthcare is health discount plans. A health discount plan is a budget-friendly tool.
It allows patients without INS or other private insurance to access affordable private care options.
In exchange for a monthly fee, patients have a certain number of discounted appointments, blood tests, and X-rays. It’s a good option for frugal patients who anticipate many tests in the future.
Who is Eligible for Medical Care in Costa Rica
Since 2010, it has been mandatory for all permanent residents to join CAJA. Approximately 7% to 11% of an applicant’s monthly income is designated as a CAJA payment. This payment covers both the applicant and any dependent spouse.
The process to obtain residency takes about 18 months. Once approved, expats must register with their nearest government regional office.
Officials will want to see proof of your residency status and all relevant paperwork. They’ll then direct you to your nearest local clinic, where you will enroll as a patient.
While awaiting your CAJA membership, you’ll have to make arrangements for your own medical costs. Most expats address this by holding private medical insurance so they’re not caught unaware by emergency expenses.
CAJA facilities are available only for emergencies involving tourists traveling to Costa Rica. In those circumstances, uninsured visitors will have to pay.
Costa Rica Travel Insurance
If you are visiting Costa Rica, you must have travel health insurance. These plans are strongly recommended to cover basic emergencies, medical evacuations, trip interruptions, and other emergencies.
Before your arrival in Costa Rica, you will want to review your travel insurance options and purchase coverage that meets your needs. A few considerations include:
- Does your travel insurance plan meet Costa Rican requirements for travelers?
- Will you be participating in any adventure sports activities?
- Will you be visiting for one week or several months?
Required Coverage for US Citizens Traveling to Costa Rica
The BCBS Global Solutions Single Trip Platinum plan is ideal for U.S. citizens and residents visiting Costa Rica.
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- For U.S. citizens and residents up to age 95
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Coverage for International Citizens Visiting Costa Rica
Patriot Platinum Travel Insurance
- Maximum limits up to $8,000,000
- IMG pays 100% of medical expenses in-network
- Evacuation due to Natural Disasters & Political Unrest
Healthcare Options for Expats and Foreigners
Expats and foreigners in Costa Rica have approximately 30 CAJA hospitals and 250 clinics to choose from.
While some buildings, especially in rural areas, need modernization, the standard of care remains high.
However, most international citizens stick to three large private hospitals: CIMA Hospital in Escazú, Clínica Biblica in San José, and Clínica Católica in San José-Guadalupe.
In particular, the CIMA hospital is especially comprehensive and offers a wide variety of specialist care. It’s also the only hospital in Central America that is accredited by the Department of Veterans Affairs.
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Maternity Care in Costa Rica
Women who are pregnant in Costa Rica are classified as preferential patients under CAJA. That means virtually no waiting times for specialist appointments.
All of your healthcare needs are met in a timely manner. All babies born in the country are automatically covered by CAJA for 1 year, including routine and emergency appointments, diagnostic tests, and other expenses.
Some expats prefer to see a private physician when they’re expecting. They feel it gives them more flexibility over when appointments take place and who they’ll see. The CAJA system is less flexible – appointments are often ‘take it or leave it’ in nature.
Traveling with your baby within the first three months of their life will require a letter of permission known as a permiso de salida from your doctor. This certifies that the child is in good health and able to travel without risk.
Understanding EBAIS and Public Health
Since 1995, the Social Security Fund has operated the Equipos Báscios de Atención Integral en Salud (EBAIS), or Comprehensive Basic Health Care Team program.
The team’s goal is to ensure that all citizens have access to medical care, especially those living in rural areas. EBAIS members work in teams of five, which include one doctor. They travel and make house calls.
The team visits residents to give vaccinations, provide basic medical care, and dispense medication. They also address public health issues, including standing water that attracts breeding mosquitoes, substandard housing, and teenage pregnancy. Even pets are taken care of and brought up to date on their vaccinations!
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