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.
Where can I purchase private health insurance in Costa Rica? - 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.
Maybe - Only one hospital system in Costa Rica will accept Tricare insurance for payment, and it requires that patients have met their deductible before billing Tricare. Very few doctors will accept Tricare for payment. The general rule for Costa Rican doctors and hospitals is that the patient must pay in advance and seek reimbursement from Tricare directly.
For those veterans and others entitled to Tricare who receive their regular medications from the DoD pharmacy by mail, it can be VERY difficult to comply with the requirements for the DoD pharmacy to dispense the prescribed drugs – a new prescription must be submitted annually by a doctor who is a licensed US physician with a DEA number. There are a very few doctors in Costa Rica who meet those requirements.
Importing medications into Costa Rica (from the DoD or other pharmaceutical providers) is another hurdle for the veteran expat.
Read #22 in these FAQs for a complete discussion about importing prescription medications.
Possibly - However, persons should be aware that some common prescription medications available in other countries are NOT sold in Costa Rica, and those sold are sometimes marketed under different brand or generic Spanish names. Persons should also be aware that the dosages of some medications sold in Costa Rica may be different than those available elsewhere. Some drugs common in other countries are not sold at all in Costa Rica. To determine if your medications are available in Costa Rica, go to a local Costa Rica pharmacy and make inquiries about the availability of the drug.
The short answer is yes. However, there are complications to that process that must be taken into consideration before attempting to have medications shipped to Costa Rica.
To receive a shipment of a prescription medication, a multi-step process must be undertaken by the recipient to comply with the rules of the two Costa Rica governmental agencies which must approve the importation and assure that correct import duties are collected. Upon the receipt of a package containing prescription medications:
1) Customs will request a copy of the original shipper’s invoice from the recipient, which shows the price paid by the recipient. This is used to determine and collect import duties.
2) The agency that is part of the Ministerio de Salud (Ministry of Health), which is responsible for approving the drug’s entry into the country, must approve the importation. To accomplish that they will require the recipient provide a “Certificate of Need,” which must be prepared by a licensed Costa Rican doctor. These certificates can be obtained from most physicians at a small cost and each certificate is valid for six-months.
Those documents must be supplied to the Costa Rica agencies via the shipping service importing the medications.
Recipients should be aware that some drugs are more difficult to import than others. An example is Xanax, which Costa Rica classifies as a psychotropic drug and therefore requires a higher level of scrutiny before importation is allowed. In those cases, besides the Certificate of Need, importation approval necessitates an additional step; the recipient must make a personal visit to the Ministerio de Salud offices and being interviewed by a doctor, explaining why the drug is needed.
Maybe - Many drugs and healthcare items which are sold over the counter (OTC) in the USA or Canada are not available in Costa Rica. Examples are Nicorette gum and PoliDent denture adhesive, which are not available here. Many other common products are similarly not sold in this market, however, some are. If a particular brand or type of OTC medication is important to you, a query about availability should be made at a local Costa Rica pharmacy.
Possibly - There are stores called macrobioticas in most neighborhoods around the country which sell many types of herbal supplements. Some supplements, however, are not available. Private importation of supplements is problematic, as they are generally prohibited by law.