Costa Rica Country Guide

Everything you need to know about moving to Costa Rica

Healthcare and Health Insurance for Expats in Costa Rica

Costa Rica has excellent healthcare options, if you can access them

Costa Rica offers high-quality healthcare, accessible medical facilities, and a strong focus on medical tourism, making it an attractive destination for expatriates seeking excellent healthcare services.

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Overview of the healthcare system in Costa Rica

Costa Rica boasts the 33rd best healthcare system globally and is recognized for having one of the finest healthcare systems in Latin America.


Medical facilities in Costa Rica come in three distinct categories:

  1. Hospitals: These hospitals operate around the clock, offering a comprehensive range of medical services akin to those found in the United States or Canada.

  2. Clinics: Clinics typically maintain operating hours from 7 AM to approximately 9 or 10 PM, providing accessible medical care within defined hours.

  3. Ébais: Ébais centers are community-based, making them an excellent choice for minor health issues and treatments.


Public Healthcare in Costa Rica: To access the public healthcare system in Costa Rica, you must first attain residency or citizenship, enroll in Caja (Caja Costarricense de Salud Social), and receive your residency card (DIMEX). Once these prerequisites are met, you can register at your local ébais (clinic). You gain the privilege to receive care at your ébais without immediate payment at the point of service. The public system permits access to healthcare at any public hospital or clinic across the nation. The system excels in preventative care, offering comprehensive health check-ups and emergency services.  However, options within the public system are relatively straightforward, and your choice of doctors is limited, necessitating flexibility in receiving care from available healthcare providers. It is also important to note that waiting times for CAJA-insured individuals can be lengthy, and certain services and medications may not be readily available.


Private Healthcare in Costa Rica: Opting for the private healthcare system grants you the freedom to select a primary care physician, specialists, and your preferred hospital. The private system is often characterized by English-speaking healthcare professionals and shorter wait times. For expatriates, particularly recent arrivals, we generally recommend relying on the private healthcare system for more personalized care and enhanced control over healthcare choices.


CAJA (Caja Costarricense de Salud Social): Costa Rica’s universal public healthcare system, known as CAJA (Caja Costarricense de Salud Social), is accessible to all residents. Upon obtaining Costa Rican residency, individuals are required to contribute to the “social security” system that supports CAJA via monthly payments.  This contribution is calculated as a percentage of your monthly income, with the fee determined by the financial amount declared in your residency application. Notably, it’s essential to be aware that CAJA fees increased in March 2022 and can range from 13% to 18%, contingent on your specific route to residency. 

Accessing Healthcare as an Expat in Costa Rica

Emergency Services: In the event of a medical emergency, 911 is the universal number to access emergency services in Costa Rica. 


Medication Availability: Costa Rica has less stringent regulations regarding prescription medication compared to the U.S. Medications can often be obtained directly from local pharmacies (farmacias) without many restrictions, providing convenient access to necessary medications.

Some recommended private hospitals:


Recommended hospitals in Costa Rica:

How to Find the Right Doctor in Costa Rica

Understanding how to navigate the Costa Rican healthcare system is crucial, but the next step is identifying the right primary care physician for your needs.


Finding the right primary care physician for you: One approach is to explore the doctor listings within hospitals. You can search listings at Hospital CIMA and Hospital La Católica. Additionally, HuliHealth, a publicly accessible platform featuring doctor listings and verified reviews, can be a valuable resource in your search.


If you’re seeking recommendations for doctors outside the major hospitals, particularly in locations beyond San José, we recommend exploring local Facebook groups specific to your Costa Rican region. For instance, groups in areas like Lake Arenal and Sámara can provide insights. You can review past posts to see if any recommendations have been shared and post your own queries. Note that these are private groups, so membership applications are typically required, and acceptance may take a few days.


Verify professional credentials: Before scheduling an appointment with a doctor, it’s prudent to check their credentials in the Costa Rican national registry. This verification ensures that the doctor is both registered and categorized appropriately for the services they offer. You can conduct a thorough doctor search here.


Ask questions and create a healthcare plan: Once you’ve pinpointed a doctor you’d like to work with, it’s advisable to schedule a check-up or wellness visit to establish a connection. Feel free to inquire about any aspects of managing your health in Costa Rica and ascertain if the doctor aligns with your requirements. Collaborate with the physician to formulate plans encompassing specialized care, medications, and emergency care contingencies to ensure a comprehensive and tailored healthcare strategy.

Accessing Medicare while living in Costa Rica

Medicare, the U.S. government’s healthcare program for individuals aged 65 and older, is generally not accessible to U.S. expatriates living abroad. While Medicare provides comprehensive health coverage within the United States, it does not extend its benefits to individuals residing overseas, with a few exceptions. Expatriates who return to the U.S. periodically and meet specific criteria may continue to use Medicare on a limited basis. However, Medicare typically does not cover medical services received abroad, so expats are advised to secure private health insurance or rely on their host country’s healthcare system for medical coverage while living abroad. It’s important for expatriates to explore health insurance options that align with their needs and circumstances when residing outside the United States.

Selecting Health Insurance as an Expat in Costa Rica

For expats without temporary residency in Costa Rica: For those without temporary residency, selecting either an international plan, choosing a plan from an international provider targeting expats like GeoBlue, Cigna Global, or Allianz International is a popular route. 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). 


Local plans offer great value to expats who will spend most of their time abroad in Costa Rica itself. INS (Instituto Nacional de Seguros), the government’s insurance provider, is one of the most affordable options for these types of plans. INS offers flexible plans, typically ranging from $50 to $250 per month, providing coverage for exams, medical visits, drugs, hospitalizations, surgeries, and anesthesia. It allows policyholders to choose their preferred doctors and access private hospitals and clinics. Notably, individuals above the age of 75 are not eligible for INS coverage.


Many expats also choose to enroll in a discount medical program, like Medismart, which offers discounts on select medical services at qualifying locations.


For expats with temporary residency in Costa Rica: Many expats that can access CAJA choose to pair public healthcare with a private plan, as well as a program like Medismart. This type of arrangement broadens access and quality of care for most health issues.

StartAbroad's Recommendation

Every expat’s healthcare and health insurance plan should be tailored to their specific case. 


In general, for individuals obtaining residency in Costa Rica, we recommend a strategic approach to healthcare coverage. A combination of CAJA and a tailored insurance plan can be a prudent choice. If your permanent residence is in Costa Rica, INS (Instituto Nacional de Seguros) often suffices. However, if your lifestyle entails frequent international travel, exploring international insurance plans may be advantageous. Including the U.S. in these plans is advisable if you spend a substantial portion of your time there; otherwise, trip insurance for shorter U.S. visits may suffice. Notably, individuals with chronic health conditions or requiring expensive medications should strongly consider private insurance.


Additionally, it’s wise to establish a relationship with a local physician on a concierge basis. This healthcare professional can serve as your primary point of contact for medical inquiries and guide you through the local healthcare landscape.


Many Costa Rican insurance policies do not cover outpatient costs. Given that outpatient fees in Costa Rica are typically more affordable than in the U.S., an inpatient-only policy may be appropriate if you don’t have existing health concerns.


Regardless of your chosen provider, it’s crucial to scrutinize the policy details, paying close attention to clauses that could lead to policy cancellation based on age. Ensuring a clear understanding of your insurance terms helps you make informed decisions about your healthcare coverage.

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