Health Insurance and Healthcare in Costa Rica Explained

Jump right in:

• How Healthcare Works in Costa Rica?
• What are the Pros and Cons of the Costa Rican Healthcare System?
• An Overview of Private Health Insurance
• How to Find a Doctor or Dentist?
• Giving Birth in Costa Rica

How healthcare works in Costa Rica

Costa Rica operates under a universal healthcare system. Expats can receive care under the public or private system. Both are deemed affordable.

Read on for an overview of Costa Rica’s public healthcare system, including the procedures covered and costs. Or you can jump to the private healthcare section.

While there is a cost difference, private healthcare in Costa Rica is still considered affordable by global standards, as the country is a popular destination for medical, dental, wellness, and health tourism.

Costa Rica healthcare facts

• Because Costa Rica is constantly upgrading its healthcare system, you can expect to see new facilities appear regularly. • Staff medical training is also updated continually. • Life expectancy in this country is high; nearly 80 years old. • The most serious diseases in Costa Rica are Dengue, Chikungunya, Zika, and Malaria. • Most medical tourists visit the country to take advantage of the high quality and affordable dental and optical care. • It’s common to use both public and private health insurance (the private insurance will supplement costs not covered by public). • Many drugs that typically require prescriptions in other countries do not here. This includes cholesterol medication, birth control, etc.

Does Costa Rica have free public Healthcare?

Costa Rica has a public healthcare system that provides services free of charge at the point of care, but it’s funded through mandatory monthly contributions to the national insurance system. This means that although the care itself does not involve out-of-pocket payments, all residents and expats must contribute to the Caja Costarricense de Seguro Social (CCSS) in order to access it. This is usually referred to as simply the Caja.

If you work in Costa Rica, the amount you pay in will be based on your salary. If you are a retired person, or rentista, who is living off of savings, the amount you pay will be based on the financial amount you declared while applying for your visa.

How does healthcare work in Costa Rica?

As an expat, you’ll need to sign up for the Caja as part of your residency process. You’ll make a monthly contribution to the public healthcare system based on your income. If you’re an employee, this contribution may fall within a range of 7–11% of your salary, while your employer is required to contribute an additional 26.67%.

It is also important to note that there are three different types of healthcare facilities in Costa Rica:

• hospitals • clinics • ebais

You can find some of the same services in hospitals and clinics such as emergency rooms, general healthcare, and specialist healthcare. Hospitals are open 24/7, whereas clinics typically operate from 7:00 to 22:00.

An ebais provides general care such as check-ups and treatment for minor ailments such as colds, sprains, etc. They are typically only open from 7:00 to 16:00.

How can a foreigner sign up for the Caja?

After you’ve applied and been approved for residency, you’ll simply can take this approval to your nearest Caja office. In addition to this approval, you’ll also need to bring:

• your passport • photocopies of your passport ID page and the page containing your entry into Costa Rica (these copies must be notarized) • proof of residency approval (plus a copy)

If you’re working in Costa Rica, you’ll also need to present a Registration Request form, which should be filled out by your employer.

Once you’ve submitted everything, you’ll be handed a receipt. You need to keep this receipt and present it when you pick up your residency card (because proof of payment to the Caja is required for your permit).

What does public healthcare cover?

There’s very little that Costa Rica’s universal healthcare system doesn’t cover. Foreigners using the public services will find everything from basic check-ups to medical treatments, medicines, and major surgeries included in the Caja.

Healthcare costs in Costa Rica

The monthly costs of public health insurance in Costa Rica vary depending on each expat’s income. Foreigners can expect to pay anywhere between 7-11% of their monthly income to the Caja. As would be expected with a universal system, the more income you receive per month, the more likely you are to pay close to 11%.

What are the pros and cons of the Costa Rican healthcare system?

What are the pros and cons of the Costa Rican healthcare system?

Given the low costs and fantastic treatment available, you may be wondering if there are any downsides to Costa Rica’s healthcare system. While the pros are many, there are a few cons expats should be aware of.

Pros

• Pre-existing conditions are covered. • There is no age limit to enroll.

Cons

• The public health system is often overrun with patients. Expats should expect long wait times. • Because the public health system is overrun, smaller hospitals and clinics may be understaffed, which can lead to even longer wait times and possibly delayed care. • Finding a specialist can be difficult, if not impossible. Most residents using the public health system are treated by general clinicians. • If you do not live in one of the major cities, it may be hard to find English-speaking staff. • You will not have a choice over which practitioner you see.

An overview of private health insurance

How does private health insurance work in Costa Rica? Although the public system is of extremely high quality and residents and non-residents have access to the same services, both Ticos and expats often opt for private coverage, too. This is because private care often includes shorter wait times, and it’s still relatively affordable.

More than one million Costa Ricans have private health insurance or are enrolled in prepaid private medical plans. The three most popular private hospitals in the country are Clínica Bíblica in San José, Clínica Católica in San José-Guadalupe, and CIMA hospital in Escazú. It is possible to pay for private treatment with cash.

Do you need health insurance in Costa Rica?

It’s not mandatory for residents to have private medical insurance in Costa Rica. This is because all legal residents must register with the public CCSS (Caja Costarricense de Seguro Social). Private insurance is supplementary and gives patients access to shorter wait times and choice over general practitioners and specialists. For foreigners, it is also easier to find English-speaking staff at private facilities.

If you move to Costa Rica — and are not yet a permanent resident — it’s advisable to get private insurance. This will help subsidize costs if you need medical care. However, costs in Costa Rica are relatively low, and private hospitals will still see you even if you don’t have insurance (public or private).

Types of Health Insurance Plans

Private health insurance in Costa Rica is offered by both public and private providers authorized by the national insurance regulator (SUGESE). If you’re unable to register with the CCSS due to your residency status, you can sign-up for the Instituto de Seguro Nacional (INS).

It’s also possible to use international private health insurance plans, such as Allianz, Cigna, Blue Cross Blue Shield, and others. If you do choose to use an international provider, make sure that you select a plan that allows for coverage outside your home country.

How to get health insurance in Costa Rica

You can register for private health insurance online. If you have a job in Costa Rica that offers health insurance coverage, your employer should take care of this for you. Often, you’ll be asked for a valid ID, financial information for direct payment, and medical history. Both foreign and local health insurance is recognized at private hospitals in Costa Rica, although the amount that is covered may vary.

To sign-up with INS, you can do so either online or in person at one of their offices. If you’re under 55 years old, you will typically need to present a valid ID, a recent utility bill showing your address, and a health declaration form. Depending on the policy, medical exams may also be required. If you’re over 55, additional requirements generally include a full medical evaluation and a detailed health questionnaire. Coverage limits or higher premiums may apply due to increased risk. It’s important to know that there is no absolute age limit for purchasing medical insurance with INS.

Health insurance cost in Costa Rica

How much is health insurance in Costa Rica? The average cost for private health insurance through the government-back INS is 31,000–129,000 CRC (approx. 60-250 USD) per month, while comprehensive international plans can exceed 516,000 CRC (1,000 USD) depending on coverage and deductibles. The range of this amount is determined by age, gender, and other factors, such as underlying conditions and your own coverage needs. Private health insurance plans from other international providers will typically be more expensive than the INS.

The INS does not cover a fixed percentage of medical costs; coverage varies depending on the specific insurance policy, with different conditions and limits for each plan.

Costs at private facilities

If you don’t have private health insurance, but still wish to use a private facility, the costs won’t be exorbitant. Regular doctors’ visits are around 30,600 to 38,250 CRC (approx. 60 to 75 USD). For specialists, the cost can be higher, typically around $100 or more. Prices for services such as x-rays and ultrasounds may vary widely depending on the facility and are often higher than 45,000 CRC (approx. 90 USD).

Using private and public health insurance in Costa Rica

Many residents and expats use both public and private health insurance in Costa Rica. This dual coverage allows greater flexibility, especially when faster or more personalized service is needed. People often use private facilities for quicker appointments or higher-quality care and rely on public services for broader, long-term coverage.

How to find a doctor or dentist

Wondering how to find a doctor or a dentist in Costa Rica? The medical practitioner you visit depends on whether you use only public health insurance, or opt for private, too.

The myth about doctors in Costa Rica

Although Costa Rica is known as a hotspot for medical tourism, many people assume that this has everything to do with the cost rather than the care. There’s a general perception that medical professionals in this country — and in developing countries in general — are not as qualified as doctors and nurses in Europe and North America.

That’s not the reality, though. The quality of care people receive in the Pura Vida country is on-par with many developed nations. Costa Rica continually requires staff to go through training in order to update and perfect medical practices.

When visiting a doctor in Costa Rica, you’ll find that many either studied or worked abroad. Because of the proximity, they have most commonly done this in the US. It is also common to find English-speaking professionals, especially if you’re in one of the bigger cities in the country. Be sure to ask about this when making your appointment, even if you go to a public facility.

How to find a family doctor

If you use only the public health system, you won’t be able to have a regular family doctor. Public health doesn’t allow residents to request a specific doctor. Or even if you do specify your practitioner, you’re not guaranteed to see them. However, it’s important to keep in mind that all medical professionals in this country are highly skilled and qualified.

If you use private insurance, it may be possible to see the same doctor when you want. Private hospitals and clinics allow insurance holders to request practitioners.

How to Find Specialists

It is easier to find a specialist in Costa Rica if you have private insurance, although the public system also offers access to specialists, usually with longer wait times. The public health scheme includes specialists, but access may involve longer waiting periods. This is one of the downsides to Costa Rica’s public system.

How to find a dentist

Costa Rica is one of the top ten countries in the world for dental tourism. As mentioned, medical practitioners here are highly qualified. You’ll find that dentists will have the latest equipment and may even have tools they have imported from abroad. Popular procedures, and their average cost, include:

Because dental services are so popular in this country, it’s easy to look up recommended dentists in your area online. There should be online reviews you can peruse, and it’s even worth giving each office a call.

Average wait time to see a doctor in Costa Rica

Wait times are one of the biggest reasons Costa Rican residents opt for private healthcare over public. If you visit a public facility, you’ll typically wait in a first-come-first-serve queue. This can take several hours. Waiting for a specific type of surgery can also last several weeks.

Often, residents choose to use a combination of public and private services in order to speed up wait times. For example, if you need x-rays, you can get them at a private institution, which will be faster than going to a public facility. You can then bring the scans to a public doctor to continue the treatment.

Giving birth in Costa Rica

Do you need to know what giving birth in Costa Rica for non-residents is like? Whether this is your first time having a child or your second or third, ensuring you know about pre- and post-natal care in your new country is essential to the health of the mother and child. Below, we walk you through the information you need in order to give birth here.

Having a baby in Costa Rica as a foreigner

All children have a fundamental right to healthcare in Costa Rica. This includes fetuses, and this right then extends to the pregnant mother as well. So, what does this mean in terms of giving birth? Can a foreigner give birth in Costa Rica without health insurance?

Yes, you can.

Expectant mothers who have moved to Costa Rica have similar rights to local residents regarding medical care and protection during pregnancy, childbirth, and postpartum, although there are some differences in access to certain social benefits. This means that while pre - and post - natal care is available, access to full benefits may depend on your legal and insurance status.

Giving birth: public vs. private care

Women can safely give birth in Costa Rica using either public or private care. There are pros and cons to both. For example, although giving birth through the public system is free, expats will usually be seen by different doctors and nurses throughout their pregnancy, depending on availability. Depending on where you live in the country, these medical professionals may speak limited English, or none at all. Some expat women have also complained of hospitals being understaffed and feeling like they did not receive the utmost care during their delivery.

If you choose to give birth in a private hospital, you have the option of selecting your own OBGYN (obstetrician-gynecologist). Private hospitals are also typically larger than public ones. The drawback to private care is that it will costs money. However, while prices are relatively low compared to other countries, having health insurance is strongly recommended, as costs can still be high depending on the hospital and type of delivery.

The cost of having a baby in Costa Rica

If you give birth in Costa Rica without health insurance and decide to use a private hospital, you’ll need to pay out-of-pocket for each appointment and procedure. Pre- and post-natal appointments will be similar to other doctors’ visits, which are around 60 – 100 USD or more, depending on the clinic. Private hospitals often offer various package options that include all related services. Delivery fees will vary depending on the type of birth:

• A vaginal delivery can cost between 1,530,000 – 2,550,000 CRC (3,000 – 5,000 USD); • C-section can exceed 3,060,000 CRC (6,000 USD).

If you have private health insurance, it may be possible to have these costs subsidized. This amount will vary dependent on your plan.

Midwives, epidurals, and water births

Expats should note that midwifery is not a recognized profession in Costa Rica. While the practice is not forbidden, it just means that there is no official qualification for it in the country. Some midwives choose to earn their certification abroad and then return to the Latin country to practice. If you’re interested in a midwife, ask your doctor or fellow expats here.

Epidurals and water births are possible in Costa Rica, but they are not common. If you prefer either, you will need to go to a private hospital. You should also confirm the use of either with your doctor, as well as verifying that your chosen hospital can provide these services.

Benefits of giving birth in Costa Rica

While Costa Rica offers access to public healthcare for foreigners, it is not completely free. Patients must generally be enrolled in the national health insurance system (CCSS) or pay out-of-pocket. One benefit, however, is that childbirth classes are often included in this coverage. Childbirth classes can be for men and women. In fact, taking childbirth classes is not a legal requirement for the father to be present in the delivery room in Costa Rica. While these classes can be helpful, they are not mandatory for participation.

Children born in Costa Rica are also given free standard vaccinations. Parents may also receive these vaccinations, such as hepatitis A and B, if they previously have not.

Giving birth in Costa Rica for citizenship or permanent residency

Any child born in Costa Rica is automatically considered a citizen, regardless of the nationality of the parents. Even if the parents are permanent residents, the baby will still be considered a citizen.

Foreigners will need to decide whether they want dual citizenship for their child or not. While Costa Rica allows dual citizenship, other countries, such as China, Singapore, and Japan, do not.

Is abortion legal in Costa Rica?

Abortion is illegal in Costa Rica except in cases where the mother’s life is in danger. An abortion is not permitted in the case of rape, incest, or if the child is proven to have a birth defect.