Healthcare in Costa Rica isn’t Free, But it is a Great Value

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.

Healthcare in Costa Rica is High Quality

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.

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 the 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.

While all citizens and legal residents living in Costa Rica are covered by the public Caja, many Costa Ricans and expats 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 service. 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 expats, 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.

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 (]


Chifrijo Jones is the nom de plume of author, adventurer, and businessman, J. Fisher.

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