Healthcare in Costa Rica isn’t Free, But it is a Great Value [UPDATED w/COVID Insurance Data]

ChifrijoJones Jul 20, 2023 9:27:25 AM

Is Healthcare Free in Costa Rica?

Although Costa Rica has a universal public healthcare system, healthcare is free only for the poorest Costa Ricans. Employed citizens and legal residents living in Costa Rica pay into the Caja Costarricense de Seguro Social (CCSS), commonly just referred to as the Caja. Payment rates are determined by monthly income (minus living expenses) and range from 5.18% and 10.69%.

Public hospitals will treat foreigners with no Caja coverage but the patient is obligated to pay for those services. So, if you find yourself in an emergency room in Costa Rica, you will get a bill, that could be significant. Most US-based health insurance policies will not cover services, including emergency services, rendered outside of the United States. However, travel medical insurance policies usually cover things like an unforeseen emergency room visit and medical evacuation.

TIP: Make sure that you have health insurance that covers you in Costa Rica in case of an emergency. Without insurance, you may have a significant out-of-pocket bill. [UPDATE SEPTEMBER, 2020] All foreign travelers to Costa Rica are required to have travel insurance which covers medical expenses and lodging expenses in the event of COVID-19 illness. Learn more.

Costa Rica’s Southern Caribbean zone can be a fun destination even during rainy season.

Healthcare in Costa Rica is High Quality

Is healthcare good in Costa Rica? 

Yes. The quality of medical care in Costa Rica is generally considered to be among the best in Latin America and at par with most post-development countries such as the United States.

In fact, the last World Health Organization ranking of national health care systems ranked Costa Rica 36th best in the world, one spot higher than the United States. 

According to the World Bank, average life expectancy in Costa Rica is 79.91 years, a full year more than that of the United States, a country with three times the GDP. In fact, the United States spends 10 times more per capita on healthcare than Costa Rica, yet the Central American country regularly ranks higher in most health outcome metrics. Poor people in Costa Rica have much better health outcomes that poor people in the United States. [source]

For most minor issues, such as a cold or allergies, a visit to the doctor isn’t even necessary. Pharmacists can treat these minor issues. Additionally, common medicines that are prescription drugs in the US, like blood pressure medication and basic antibiotics can be purchased over the counter.

The public Caja system has 30 hospitals and at least 250 clinics throughout the country, that serve almost 5 million residents of the country.

Caja coverage is mostly funded by the aforementioned payroll tax. Some low-income residents don’t pay into the Caja system for lack of ability. These people receive free healthcare in Costa Rica, primarily funded by a tax on luxury goods, liquor, soda, and imported items. 

While all citizens and legal residents living in Costa Rica are covered by the public Caja, many Costa Ricans and ex-pats also choose to take private insurance. There are policies available via the state-owned Instituto Nacional de Seguros (INS), as well as private carriers. The benefits of private coverage are:

  • More doctors from which to choose
  • More hospitals from which to choose
  • Shorter wait times

Many patients use a mixture of public and private providers. For example, surgery may take place in a public Caja-paid facility, performed by doctors that are paid through a private insurance policy.

Health insurance premiums for private coverage in Costa Rica usually cost 30% to 50% of comparable coverage in the United States.

TIP: If you are planning on taking legal residency in Costa Rica, explore private health insurance options for shorter wait times and better choice.

CIMA Hospital

Arguably, the best hospital in Central America is CIMA, located in Escazu, the upscale San José suburb. It is a private hospital with high-quality, world-class medical services. CIMA is accredited by the Joint Commission International and recognized for its rigorous standards of care.

More than a quarter of patients at CIMA are from a country other than Costa Rica. It is popular with foreign ex-pats, permanent residents, and medical tourists.

CIMA has state-of-the-art equipment, including an open MRI.

Clinica Biblica

Clínica Bíblica, in downtown San José, is the oldest private hospital in Costa Rica. It was founded by Christian missionaries in 1929.

There is a Clínica Bíblica location in the upscale Central Valley town, Santa Ana, as well as Quepos, and, Cabo Velas de Santa Cruz. They also operate a cancer center in La Uruca, on the northwest side of San Jose.

Like CIMA, Clínica Bíblica is JCI-accredited for a high quality of care.

Hospital La Católica

Hospital La Católica is located in Guadalupe, on the northeast side of San Jose. This hospital openly markets itself to medical tourists.

Health and Quality of Life in Costa Rica

The Costa Rican lifestyle is generally considered to be healthy. Ticos tend to eat few processed foods, instead favoring fruits, vegetables, rice, and beans. Seafood and chicken are popular meats. 

Access to quality locally-produced food is the norm in Costa Rica. Hundreds of farmer’s markets, known as ferias de agricultores in Spanish, take place on Friday, Saturday, and Sunday throughout the country. Local farmers sell fresh vegetables and fruit, like plantains, pineapple, carrots, bananas, rambutan (mamon chino), goldenberries (uchuvas) and onions. 

If you miss the weekend farmer’s market, you can always visit the local central market, which is open during the week, with vendors selling produce, meat, beans, rice, and other staples. 

Nicoya Blue Zone

There is part of Costa Rica, on the Nicoya Peninsula, which is one of the so-called Blue Zones, where residents often live to 100 years old or older. According to author Dan Buettner, Nicoya, like the other Blue Zones, share nine characteristics. They are:

  1. Having a reason to live
  2. Focusing on the family
  3. Fostering social networks
  4. Working hard
  5. Engaging in natural physical activity
  6. Living a healthy lifestyle with a healthy diet
  7. Drinking water rich in minerals
  8. Getting a moderate amount of sun every day
  9. Practicing religious faith

Many foreigners who retire to Costa Rica cite the healthy lifestyle as a major factor in their decision to choose Costa Rica. 

Medical Tourism

Costa Rica receives an estimated 40,000 medical tourists every year. Foreigners, often from North America, travel to Costa Rica for surgeries and other treatments that would be prohibitively expensive in their home countries.

The cost of some surgeries, such as knee replacement and heart valve replacement, is 60% to 70% less than in the United States.

Almost half of medical tourism to Costa Rica is for dental work. It’s no wonder because the cost of dental care is much more reasonable than in other places. For example, a single crown can be as low as $350. A root canal with post and crown can be as low as $750. Implants run as low as $1,600.

TIP: If you need expensive dental work, look for good value in Costa Rica

While healthcare in Costa Rica isn’t free, except for the poorest Costa Ricans, the level of care is high and the associated cost represents a great value.

photo credit: Rodtico21 [CC BY-SA 3.0 (]

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