This Is Why Expats Are Healthier in Costa Rica

Costa Rica has a lot to recommend it: low cost of living, bargain real estate, the “Pura Vida” lifestyle, great weather, fabulous beaches…the list goes on and on.

But one of the biggest benefits for retirees, business owners, and other expats is the health care. In a time of rising costs in the U.S., not to mention a contentious political debate over insurance and medical care, Costa Rica’s take on the issue is refreshing.

Health care is cheap and easy to access.

And you’re not sacrificing standard of care. The doctors—many of whom trained in the U.S., Canada, or Europe—know all the latest techniques, and clinics and hospitals have modern tools and equipment like MRIs.

There are two health care systems operating side by side in Costa Rica. All citizens and legal residents get access to the government-run system known as Caja. An expat interested in retiring to Costa Rica would simply need $1,000 a month income from Social Security, a pension, disability, or other source to qualify for pensionado (retiree) residency status—and their spouse joins them. Then they pay a low monthly fee based on income (usually between $60 and $120) to join Caja. After that all their care in the public system is free, including doctor’s visits, diagnostic testing, prescriptions, and major surgery.

Expats who use public facilities give it generally high marks. One expat I met who lives on the southern Pacific coast near the town of Ojochal got his first taste of the Caja after falling 12 feet or so from a ladder. A friend rushed him to the nearest emergency room about 30 minutes away. He was seen immediately, was X-rayed to check for broken bones, and examined for a concussion. Luckily, he was just pretty badly bruised. He reported that all the staff were very caring and that the doctor, who spoke fairly good English, made time to make sure he understand the diagnosis.

But there are drawbacks. Wait times for testing, like ultrasounds, CT scans, etc., can be weeks or months in non-emergency situations. It’s the same with non-emergency surgery. And while doctors often speak English, most nurses and administrative staff do not, which can be frustrating when trying to navigate a hospital or following up on test results.

The wait times are one reason many expats tend to use a mix of the Caja and private medical care, in which you are generally seen within days, if not hours. There are private hospitals, clinics, and doctors throughout the country. But like the public system, the best private facilities and most specialists are in and around San Jose, Costa Rica’s capital.

When you go private, you can use insurance, including international policies, or you can pay cash. But even if you’re out of pocket, it’s very affordable. A visit to your general practitioner runs $50; specialists are $80-$100. And it’s no five-minute visit. Physicians really take time with you; they’re not in a rush. I’ve never talked to my doctors for less than 30 minutes. I even have all their cell phone numbers for emergencies and questions.

Procedures are cheap too. When my son needed an ultrasound to check out an issue with his kidney, we headed to a small private clinic near our home in the Central Valley. Total cost was $70—and the test was done by a radiologist, not a technician. We got the results immediately—on CD—to take back to the pediatrician.

And ultrasounds aren’t the only thing that are a fraction of the cost of the U.S. Generally, surgeries are half, a third, even a quarter of the cost. It’s the reason Costa Rica has become a top medical tourism destination for cosmetic surgery, knee and hip replacements, heart surgery, cosmetic dentistry, and more.

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