You don't have to be entering your golden years to dream about starting a new life in Costa Rica. This idyllic country is home to incredible wildlife, boasts stunning natural landscapes, and has a temperate climate.
Even better, Costa Rica is just a short flight away from the U.S. – and, as an added bonus, the healthcare in Costa Rica is touted as one of the most affordable and comprehensive in the world. In fact, Costa Rica's healthcare system is ranked above the U.S., New Zealand, and Cuba.
Suppose you – like many Americans – are considering moving to this tropical paradise. In that case, there are five things you should know about Costa Rica health insurance and how the healthcare system works.
1. Costa Rica's Public Healthcare System Isn't Perfect
75 years ago, universal health insurance was introduced in Costa Rica and has been a huge part of the country's culture ever since. Naturally, the citizens are incredibly proud of their country's achievements over the last seven decades.
But, although the healthcare system is both affordable and comprehensive, it could be better. There are many complaints about bureaucracy, extremely long waiting times, and a drop in standards within rural facilities. In fact, these rural facilities desperately need upgrades, more staff members, and better equipment.
Many people who move to Costa Rica find that the healthcare facilities are overcrowded and not as private as the facilities in their home country.
2. There Are Private and Public Healthcare Options
"La Caja" – short for "Caja Costarricense de Seguro Social" (CCSS) – is the name of the public healthcare system in Costa Rica. The CCSS is funded mainly by taxes. The rate the public pays for public healthcare is based on a person's income – generally around seven to eleven percent.
The second system, "INS" – an abbreviation of "Instituto de Seguro Nacional" – is a type of private health insurance system run by the government. Choosing INS will give you access to dental coverage, annual checkups, and optometry, and you can visit private clinics and hospitals.
3. Expats Are Part of the Public Healthcare System
Costa Rican citizens aren't the only ones who benefit from the public healthcare system – anyone with legal residency must use La Caja. However, not all expats are thrilled with mandatory enrollment in Costa Rica's public healthcare system.
Expats who already have private health insurance in their home country may not want to complete additional paperwork to sign up for healthcare they won't use. However, there are benefits – particularly when it comes to cost. Some private healthcare facilities demand a large cash payment before beginning treatment. Additionally, not every hospital will bill a private insurance company directly – which can put a financial strain on patients who cannot pay a lump sum upfront. Thankfully, visits to public emergency rooms are free, and you will only incur small costs for items like knee braces, etc.
4. Patients Can Choose a Mixture of Public and Private Healthcare
Expats and citizens in some countries are forced to choose either public or private healthcare. In Costa Rica, however, you can select a mix of both.
Many people choose La Caja because it is cost-effective and emphasizes community wellness and preventative care. In contrast, others choose INS because it generally has shorter waiting times and offers access to a wide range of healthcare specialists.
The two healthcare systems complement each other quite well. In fact, many patients opt to have diagnostics like radiology done at a private facility to avoid long waiting times and then have a public doctor review the results. Healthcare professionals working within the INS system also know how to prescribe medication from La Caja pharmacies to save their patients money.
It's also common for expats to opt out of INS and choose private health insurance from an independent provider. Usually, expats already have their own health insurance via work benefits. In these cases, you may have to pay for care upfront and be reimbursed at a later date.
5. The Costs Are Reasonable, but Not Always Free
La Caja provides legal residents and citizens with comprehensive coverage for appointments, procedures, prescription drugs, and hospital visits. However, La Caja coverage may not cover administrative requests and non-prescription medicines (such as vitamins).
Short-term expats and tourists not enrolled in the La Caja system will generally find healthcare costs in Costa Rica more reasonable than in many other countries. Diagnostic procedures like blood tests and ultrasounds usually cost $100 or less.
Most health care – from surgeries to routine checkups – is around 70 percent cheaper in Costa Rica than the same procedures in the U.S. However, it bears mentioning that even 20 or 30 percent of an enormous hospital bill can still equate to a large sum of money.
Those who take care of their health (and don't need a lot of healthcare coverage) but still want to safeguard themselves against unforeseeable healthcare bills can choose an insurance plan with low premiums and a high deductible to ensure they are covered for emergencies.
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