Healthcare in Costa Rica for American Retirees
Healthcare in Costa Rica
How healthcare works in Costa Rica for a foreign resident: what the public system will and will not do for you, what private cover costs, and where the system is weak.
Costa Rica has the best health system in Central America and one of the best in Latin America, with life expectancy that exceeds the United States. There are two tiers: the Caja, a universal social insurance system that residents must join, and a well-developed private sector concentrated in the San José metropolitan area.
Access to the public system
Enrolment in the Caja is compulsory for residents and is a condition of getting your residence card. Contributions are assessed on declared income, commonly 7 to 11 percent, and cover everything including prescriptions, surgery and long-term care with no deductible and no exclusion for pre-existing conditions. That last point is enormously important for anyone who cannot get private cover.
What private care costs
A private specialist consultation runs 60 to 120 dollars. The three main private hospitals, CIMA, Clínica Bíblica and Hospital Metropolitano, are all in the San José area and are internationally accredited. Private insurance through INS or an international insurer typically costs 100 to 300 dollars a month depending on age.
What the visa requires
Most retirees carry both: the Caja for catastrophic cover and pre-existing conditions, and either private insurance or self-pay for speed and convenience on routine care. Caja waiting times for non-urgent specialist appointments and elective surgery are long, which is exactly what the private tier solves.
Where it is strong
No exclusion for pre-existing conditions in the Caja. Excellent outcomes. Dental and cosmetic care draw significant medical tourism. Prescription costs are a fraction of U.S. prices.
Where it is weak
Caja waiting lists. Almost all high-end care is concentrated around San José, so a beach town two hours from the capital means a two-hour drive for anything serious. Rural clinics are basic.
Medicare
Medicare does not cover you in Costa Rica.
Healthcare in Costa Rica: common questions
Will Medicare cover me in Costa Rica?
No. Original Medicare does not pay for care outside the United States except in a few narrow situations. Most retirees keep premium-free Part A, make a deliberate decision on Part B based on how often they will return to the U.S. for care, and buy local or international cover.
Can I use the public system in Costa Rica?
Enrolment in the Caja is compulsory for residents and is a condition of getting your residence card. Contributions are assessed on declared income, commonly 7 to 11 percent, and cover everything including prescriptions, surgery and long-term care with no deductible and no exclusion for pre-existing conditions. That last point is enormously important for anyone who cannot get private cover.
What will insurance cost?
A private specialist consultation runs 60 to 120 dollars. The three main private hospitals, CIMA, Clínica Bíblica and Hospital Metropolitano, are all in the San José area and are internationally accredited. Private insurance through INS or an international insurer typically costs 100 to 300 dollars a month depending on age. Most retirees carry both: the Caja for catastrophic cover and pre-existing conditions, and either private insurance or self-pay for speed and convenience on routine care. Caja waiting times for non-urgent specialist appointments and elective surgery are long, which is exactly what the private tier solves.
Verified Sep 7, 2026 Primary sources: www.migracion.go.cr, www.ccss.sa.cr, arcr.cr
This resource is provided free by Federal Apostille as an educational tool. It is not legal, tax, immigration or financial advice, and no attorney-client relationship is created by using it. Immigration rules, income thresholds, fees and processing times change frequently and often without notice, and consulates apply them differently. Always confirm current requirements with the official government source and the specific consulate that has jurisdiction over your U.S. state of residence before you act. Every figure on this site carries the date we last verified it and a link to the primary source.
