There are two types of health insurance available in Costa Rica: the CAJA and private insurance.
What is the CAJA?
The CAJA is the common name for the Costa Rica Social Security system (CCSS.) Among other things, the CCSS provides and manages healthcare services to Costa Rican citizens and residents.
The CAJA healthcare system is comprised of hospitals, clinics, doctors, and pharmacies, all of which are available to every citizen and resident at no cost (expats must pay a monthly membership charge. See below.)
Healthcare is generally of the highest standard, however there can be delays in treatment for minor illnesses due to the high number of users.
The CAJA maintains a separate hospital exclusively for the elderly. Admittance for resident expats, is by referral from a CAJA doctor only.
How do I join the CAJA?
Joining the CAJA is mandatory when applying for residency. Non-residents, those on a Tourist Visa, are not allowed to join.
Expats joining the CAJA must pay a monthly payment (similar to an insurance premium) based on several factors, including age and income. The amount of the monthly payment is determined at the time of enrollment and can be significantly less than commercial health insurance payments.
ARCR will assist MEMBERS who are applying for residency becoming enrolled in the CAJA and obtaining the lowest monthly rate. However, those who prefer to “do-it-themselves” can take the proof of the acceptance of their residency application to a local CAJA office and enroll there. This may, however, result in a higher monthly payment.
(All CAJA employees are Spanish speakers and non-Spanish speakers may find the enrollment process difficult.) ARCR MEMBERS can also enjoy a free service not available anywhere else; automatic monthly payments to the CAJA, billed directly to their credit card.
There are several private health insurance providers in Costa Rica. Health insurance can be cheaper than in other countries, but can be expensive or unavailable if pre-existing conditions are an issue.
ARCR has a dedicated insurance office on premises with trained agents who can assist MEMBERS to purchase private healthcare insurance at a reduced cost.
Note: Many foreign health insurance providers will NOT pay claims for medical treatment in Costa Rica, and some private Costa Rica hospitals will not accept those policies for payment; they require the patient to pay up front and seek reimbursement from their insurance company on their own. A few North American insurance companies WILL pay for treatment outside their home areas. Check with your insurer.