This is so important! Health Insurance Options for Expats in Costa Rica

I keep getting emails from all of you awesome folks asking about healthcare in Costa Rica. This week, that conversation goes in-depth with health insurance options for expats.
 
The great news is that Costa Rica has a fantastic healthcare system that's accessible to locals and foreigners alike (in part). And more and more people are going down to Costa Rica just to get a procedure or surgery, which would cost them way too much or be impossible to get in the U.S. (Canadians have that covered!)
 
Even if you’re not an official resident and therefore don’t qualify for Caja, you have other options for great healthcare in Costa Rica. Many expats and visitors opt for a combination of Caja, private pay and also keep their U.S. health insurance coverage to patch together the best possible medical coverage. 
 
Here are a few other options outside of Caja: 

INS (Instituto Nacional de Seguros) 
INS offers medical insurance autonomous of Caja. It’s a group plan offered by the Association of Residents of Costa Rica. It’s a government- run private plan (you’ll never see that in the U.S.!) that is available to legal residents or non-residents who pay into the system. If you sign up with INS, you’ll have access to about 200 affiliated doctors, hospitals, labs, and pharmacies throughout Costa Rica. 

However, it does have a limit of $17,500 per year for treatment costs and does not cover pre-existing conditions or routine check-ups.
INS pays out 80% of the cost for prescription drugs, examinations, doctor visits, hospitalization and treatment and 100% of surgeons’ and anesthetists’ fees. 

The costs for NIS range from $60-$130 per month based on gender, age, and other health factors. 
 
International health insurance policies: 
If you’re not yet a resident of Costa Rica or will be going back and forth to the U.S. or traveling to other countries frequently, you might want to check out your options with international health insurance. 

There are a handful of companies that offer insurance plans that will cover you anywhere you go in the world – including Costa Rica.
Unlike the INS option that has an annual premium cap of $17,500 and excludes preexisting conditions, most worldwide health insurance plans cover up to a $2 million up to a $5 million lifetime limit. 
 
The premiums might be a little higher than you’ll pay with INS or Caja, but they usually cover far more and offer greater flexibility.
Just bear in mind they may reduce your premiums if you specify that you’ll only need coverage in certain countries. 
 
For instance, most of them will still cover you when you go back to the U.S. (we exclude Canadians from this conversation because they have their health insurance all set up!) as long as it’s for 30 days or less. Plans do differ so check out some of the biggest international health insurance providers like Bupa International Insurance. 
 
None – be your own insurance company: 
With the sky-high cost of medical treatment in the U.S., it’s ingrained in us that we need a health insurance plan at all times to cover our medical needs. However, some expats choose not to carry medical insurance in Costa Rica at all. 
 
Instead, the logic goes that they can just save the cost of the monthly premium in their own savings account, and have it there to pay for any private medical care if needed since the cost of health care is so reasonable in Costa Rica. 
 
While I’d still never recommend going without some major medical plan in case of serious accidents, sudden sickness, and hospitalizations, but for expats who are in great health and have significant savings as a safety net, this is a viable option. 
 
Again, I wouldn’t recommend this long term and maybe look at travelers insurance or something temporary so that you have base coverage on your way to establishing residency and Caja. 
 
U.S. based health insurance: 
Some U.S. citizens that move to Costa Rica choose to keep their U.S. based health insurance coverage, whether that comes from Medicare, our government-run healthcare system, from a spouse, or an old employer. 
 
They may pay out of pocket for basic care in Costa Rica like doctor’s checkups and dental cleanings, but then go back to the U.S. for more major care or procedures. 
 
If you have affordable health insurance – maybe subsidized with credits so the monthly premiums are low – you may want to keep this option and just get annual medical care taken care of when you make the trip back to the states periodically. 
    
But, for most expats that don’t have affordable care taken care of back home, this might not be a great long-term choice. 

The healthcare conversation is SO important for expats or visitors in Costa Rica, and I have lots of great, invaluable information for you in the Moving to Costa Rica Handbook!

-Norm  :-)

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