With all of the emails I get from people thinking about moving to Costa Rica, one of the three most common questions is always about healthcare.
It’s not hard to fathom why (they’re usually from the U.S.A. – not Canada, of course) with health insurance premiums and prescription drug prices skyrocketing in the ever-more confusing and ineffective system of medical care in the states.
So, what can you really expect when it comes to healthcare if and when you relocate to Costa Rica?
The great news is that Costa Rica has a top notch system of medical care with plenty of options for expats, from utilizing their state-run socialized system for residents, opting for affordable private healthcare insurance, paying out-of-pocket, or mixing in a combination of U.S. and travel insurance coverage.
You should be encouraged by the quality of Costa Rican medicine, too. It’s no coincidence that Costa Ricans are some of the healthiest people in the world, with higher life expectancy and lower infant mortality rates than those in the United States. In fact, the World Health Organization frequently ranks Costa Rica well ahead of the United States and all other Central American countries for healthcare.
The amazing thing is that Costa Rica earns all of these accolades for its medical care even though healthcare spending is 87% less per capita than in the U.S.!
So as an expat, resident or just visitor to Costa Rica, you’ll enjoy great quality care for surprisingly reasonable prices.
La Caja, Costa Rica’s national healthcare system:
The state-run health system is called the Caja Costarricense de Seguro Social, or CCSS. However, you’ll almost always hear it referred to as, “la Caja” or just “Caja.”
It includes medical care in any of the 30 hospitals and 250 clinics throughout Costa Rica in this government-sponsored network.
All citizens and legal residents to Costa Rica get access to Caja.
Each member is required to pay a small monthly fee into Caja based on their individual income.
Costa Rican employees each pay 9% tax to fund this health insurance, with employers paying an additional 18%.
Tourists are eligible and should ensure they have adequate health insurance. However, tourists won’t be turned away from Caja medical facilities in case of emergencies.
But for those expats who plan on retiring or living in Costa Rica, it probably is worth it to establish residency, and therefore get access to low-cost medical care through Caja.
In fact, if you’re going to be a legal resident of Costa Rica, paying into Caja is REQUIRED – you can’t get any form of residency without proof of existing Caja coverage.
You just need to show at least $1,000 monthly income from Social Security, a pension, disability, or any other source to qualify for pensionado (retiree) residency status. Your spouse can even qualify as well.
Once you’re a resident, you’ll only need to pay the low monthly fee based on your income (usually between $60 and $120 for modest incomes) to join Caja.
As a member, you’ll enjoy all the benefits of Costa Rica’s public healthcare system, including free doctor’s visits, diagnostic testing, prescriptions, dental, eye health, and even major surgeries.
There’s no upper limit on the annual amounts paid out by the plan for your healthcare – and you’ll never just be canceled or see your premiums balloon like in the U.S.
An individual doctor and clinic are assigned to each patient, but you can arrange to bill for Caja through many private doctors and hospitals, too.
What’s the downside of Caja?
While it is highly accessible and inexpensive, remember that Caja is socialized medicine. You’ll probably still find it more efficient and user- friendly than many U.S. health plans, but do be prepared for long lines and generic medicines.
Wait times for testing like ultrasounds, CT scans, etc., can be weeks or months in non-emergency situations, and you may have long waits to schedule advanced surgeries or appointments with specialists. However, for the vast majority of low-middle income groups, Caja is a fantastic medical care option.
You’ll find that many of the doctors speak English, but most of the nurses and administrative staff do not, which can prove difficult when it comes time to talking about medical diagnosis and options. So you may want to bring a local Tico with you to help with translation.
Coming up in future blogs, I’ll cover health insurance options for expats in Costa Rica (more good news!), dentistry in this country, as well as typical costs for procedures and surgeries.
The Official Expat,
Want the full prognosis on medical care, health insurance, and other aspects of living as an expat in Costa Rica?
Check out The Official Expat's Moving to Costa Rica Handbook!
Don't miss the #1 resource for moving to Costa Rica and living the dream here.
Download for free here.