For anyone moving anywhere (even one state over), healthcare access and medical providers are always a big question mark. These are the things you need to know. And so, as you consider your move abroad, you’re now wondering – what is Costa Rica healthcare really like?
I’m glad you asked!
You can start by taking a deep breath; there’s no bad news coming down this pike. Costa Rica’s healthcare, both public and private, is good. Excellent, even. The only real challenge involves deciding how you’ll structure your healthcare – public, private, or a little bit of both? – and whether you require access to anything specific, from a certain type of specialist to English-language healthcare providers.
So, let’s get into it: public healthcare, private healthcare, and everything in between.
Costa Rica’s Public Healthcare: The CCSS, aka the “Caja”
You may have heard that Costa Rica has “some of the best” public healthcare in the world. And, that’s true. According to the WHO ranking, Costa Rica healthcare is the 36th-best in the world. That’s higher than the United States (at #37) and boasts an above-average lifespan that, as of 2019, stands at 80.3 years (vs. 79.1 years for the U.S.).
That said – and especially if you’re from the U.S., which doesn’t have anything like Costa Rica’s socialized healthcare – I know you’re wondering what public healthcare is really like here. That’s what this post is about. Partially, at least!
Costa Rica’s public healthcare system is called the Caja Costarricense de Salud Social, or the Costa Rican Social Healthcare Fund. In Spanish, almost everyone refers to it as “la Caja” (lah cah-hah).
As a resident, you’re required to contribute to the Caja. Your monthly rate is a function of your monthly income but it’s not straightforward enough to calculate for yourself. You can expect to pay 5% to 12% of your monthly income; this fee will include all healthcare and contributions to your pension fund. (Note that, as of 2022, all resident Caja payments include the pension contribution, even for retirees.)
Importantly, you’ll never pay anything additional to your monthly fee. Every exam, every test, every prescription medicine, every surgery – you’ll never pay a copy, coinsurance, deductible, or other out-of-pocket expense for Caja services.
The Pros and Cons of the Caja
If that all sounds like paradise, then this is where I jump in with a hit of reality. Costa Rica healthcare is excellent and the Caja does many things very well. But it’s not all sunshine and puppies.
- Preventive Healthcare: The Caja is literally built on public healthcare, not sick care. (This New Yorker article does a great job of explaining the difference.) As such, the system does well with your standard well care, from biannual blood panels and yearly checkups to colonoscopies and cancer screening.
- Emergency Healthcare: If you need emergency healthcare, especially in the case of an accident or traumatic event, select Caja hospitals are equipped with the best technology in the country. You also stand to save huge amounts of money, considering how expensive life-saving measures can be.
- ✅ Pre-Existing Conditions: Costa Rica healthcare is a right and, therefore, the system will accept any and all pre-existing conditions.
- Limited Inclusions: Public healthcare comes with a public budget. That means that the Caja typically limits its resources to cover the most common, the most used, and the most needed. As a practical example, that could mean that your current off-label or uncommon prescription may not be included in the Caja’s list of available medicines. (And paying out of pocket can get expensive.)
- Wait Lists: Costa Rica healthcare can be a waiting game. And by that, I mean the long game. You can wait for months for a well visit and years for non-urgent surgery. (Emergencies go to the front of the line.) See you then!
- Impersonal Medicine: Because of how the Caja is managed (and it’s complicated, so I won’t go into all the details), you likely won’t develop a personal relationship with “your doctor.” It’s a little like stepping into an emergency room: you get whoever is on call that day. Only, every time you visit the clinic, the specialist, the hospital… This can even be true over a specific issue; for example, if you need a hip replacement, you may speak to three different orthopedic surgeons on three different days.
Costa Rica Healthcare: Private Options
At some point, most residents and many Costa Ricans will see a private doctor or healthcare professional. That’s because Costa Rica’s private healthcare system is not only excellent but fairly well priced. There’s a reason why medical tourism is so popular here!
While the topic of private healthcare could constitute its own book, let’s take a look at the basics. Starting with the three most common payment options:
- Out of Pocket: If you’re planning the occasional doctor’s visit or lab test, you can easily pay these out of pocket (with no insurance). As an example, a general doctor’s visit (sick or well) costs $50 to $70; specialists run $80 to $130; and a simple blood panel is about $20 to $30.
- Private Insurance: If you plan on using private Costa Rica healthcare often, then you’ll probably want to purchase private insurance. Note that, as expected, private insurance does not cover pre-existing conditions and it can get pricey. Costs and companies vary but you’re probably looking at $125-$500+ per month, with a deductible and typically covering 80% of costs.
- Medical Membership/Discount Plan: Discount plans like Medismart and Mi Vida offer access to select medical networks and very good discounts – anywhere from 15% to 80% off standard rates. For example, a Pediatrician visit through Medismart is about $20 total (vs. $100 at full rate).
Often, residents will cobble together a works-for-them approach to Costa Rica healthcare: For example, use Caja for well care and emergencies + a paid membership plan for the occasional sick visit or specialist; or use Caja for emergencies and purchase private insurance for everything else.
So, with that in mind, here’s why you might (or might not) want to use private healthcare in Costa Rica.
Private Healthcare Pros:
- English-Language Healthcare: English-speaking doctors are luck of the draw with the Caja. If you require English-language medical care, private is the way to go.
- Huge Network: The network of private Costa Rica healthcare is vast. No matter where you live, you’re likely close to general care and a short drive to specialized care. (Caja specialists can be harder to access, if you live in a rural area.)
- Short Wait Times: Need an appointment in an hour? Private healthcare can do that. Want surgery next Tuesday? That, too.
- Closer Patient-Provider Relationships: If you highly value building a relationship with your healthcare providers, then you will appreciate the flexibility and personable nature of Costa Rica’s private healthcare providers.
Private Healthcare Cons:
- The Cost: There’s no way around it: Private healthcare can get expensive. Whether you’re paying piecemeal or going through insurance, the more medical services you need, the higher the cost. (Insurance premiums also hike for senior citizens.) Still, let me put it in perspective: A typical birth runs $10,000-$25,000 in the U.S. The out-of-pocket, no-insurance cost here is $5,000.
I know – just one con? It’s true. There’s no major downside to choosing private healthcare, beyond the cost. But, depending on how major your medical needs, this can be a five- or six-figure out-of-pocket con. Which brings me to…
Mixed Medicine: The Other Option in Costa Rica Healthcare
Did you know there was a third, sort of in-between option to Costa Rican healthcare? Call it a hack, if you will.
Mixed medicine is a popular and well-known approach to getting the most out of Costa Rica healthcare. It works like this: Many Caja doctors also work in private practice. With this in mind, you can mix private services (ex. a private specialist with a doctor who also works for the Caja) with Caja prescriptions and other public healthcare services.
It’s not quite jumping the line, but it’s close. You could call mixed medicine a fast track, at the very least. Even better, you can get in with a public doctor who speaks English, which can be a huge benefit as you work your way through learning the public system.
Questions about Costa Rica Healthcare & Life in Paradise?
Hi, I’m Rebecca Clower. (My friends call me Becky.) In 2006, I did what you’re preparing to do: I followed my heart and moved to Costa Rica.
For nearly two decades, I’ve learned the ropes. That includes everything from having surgeries and getting sick (and learning the public/private systems!) to raising kids and moving many times. I’ve really made my home here.
Along the way, I founded one of Costa Rica’s most successful independent brokerages. And for years, I’ve made it my job to help other people do the same. I offer real, honest advice and expertise to my clients. I promise not to sugarcoat the hard truths or gloss over the tough parts. I will tell you the whole truth, the full truth, and even the hard truths.
I hope that you’ll find the beautiful truths to outweigh them all. So, sign up for updates, download my free eBook, and get in touch. Let’s get started!