Health Insurance in Costa Rica: A Complete 2025 Guide for Expats and Property Buyers
Costa Rica, with its stunning landscapes from the vibrant sunsets of Tamarindo Beach properties to the serene beauty of Flamingo Beach properties, is more than just a paradise for living and investment. It’s also renowned for its high quality, accessible healthcare system. For those considering a move to Guanacaste, or anywhere in this beautiful country, understanding your healthcare options is a key step. The robust healthcare system, combined with the convenience of living near the Liberia Airport, makes a move to this region an incredibly appealing prospect.
Our company, Summer Coast Realty, is proud to help you find your dream home, whether it’s near our exclusive Flamingo Beach properties office or a charming coastal villa near the Tamarindo Beach properties office. As the Broker and CEO, Lindsey Cantillo, I am committed to ensuring your transition is as smooth as possible, and that includes understanding important aspects like health insurance in Guanacaste.
Costa Rica's reputation for high-quality healthcare
Costa Rica holds a strong international reputation for its high-quality healthcare, offering a blend of universal public coverage via the CCSS (the “Caja”) and excellent private facilities at lower costs than many developed countries. The system is supported by a focus on preventive care, a high number of well-trained doctors, including those with international experience and English proficiency, and a commitment to modern facilities and electronic health records.
Costa Rica holds a strong international reputation for its high-quality healthcare, offering a blend of universal public coverage via the CCSS (the “Caja”) and excellent private facilities at lower costs than many developed countries. The system is supported by a focus on preventive care, a high number of well trained doctors, including those with international experience and English proficiency, and a commitment to modern facilities and electronic health records. While the public system faces strains like long waiting times for certain procedures, the combination of affordability, quality, and access to international standards makes it a top destination for medical tourism and expats.
While the public system faces strains like long waiting times for certain procedures, the combination of affordability, quality, and access to international standards makes it a top destination for medical tourism and expats.
Why Costa Rica’s healthcare is highly regarded:
- Universal Public System (Caja): The CCSS provides comprehensive medical coverage for citizens and legal residents, ensuring access to essential services, routine doctor visits, emergency care, and hospital stays.
- High-Quality Private Sector: Private hospitals and clinics, like Hospital CIMA, offer modern facilities and services on par with first world standards.
- Affordability: Both public and private care are significantly less expensive than in many Western countries, making quality medical treatment accessible to a wider range of people.
- Emphasis on Preventive Care: The country’s focus on public health initiatives and promoting healthy lifestyles contributes to positive health outcomes.
- International Standards: Many facilities are JCI accredited, a global benchmark for quality and patient safety.
- Skilled Medical Professionals: Costa Rica has a high ratio of medical professionals, many of whom are highly trained and fluent in English, serving tourists and expats.
Considerations for using the system:
- Public vs. Private: While the public system offers broad coverage, it can have long waiting times for some procedures, leading some individuals to use private facilities for faster service.
- Expat & Tourist Options: Expats and tourists can access healthcare by paying directly for services or by obtaining private insurance.
- Travel Insurance: For visitors, travel health insurance is mandatory and should be researched to ensure it meets local requirements and covers planned activities.
The Public Health Insurance System (CCSS / Caja)
Private insurance serves as a supplement to CCSS, offering faster access, more provider choice, English-speaking staff, and more modern facilities. Costa Rica offers a comprehensive healthcare system that combines public and private options, making it an attractive destination for those seeking quality and affordable healthcare services. The country’s healthcare industry is known for its accessibility, affordability, and high standards of care. Whether you are a resident or a visitor, you can rest assured knowing that you have access to excellent medical facilities and healthcare providers in Costa Rica.
Overview and Coverage
Administered by the Caja Costarricense de Seguro Social (CCSS), Costa Rica’s universal public health provider. The Costa Rican Social Security Fund is in charge of most of the nation’s public health sector. Its role in public health (as the administrator of health institutions) is key in Costa Rica, playing an important part in the state’s national health policy making. Its services are available to all citizens and permanent legal residents.
This governmental entity’s functions encompass both the administrative and functional aspects. Originally, services were carried out at private hospitals but funded by the Costa Rican Social Security Fund. Not until the mid 1960s did the Caja begin constructing its own hospitals staffed by public employees. It has the obligation (as a public institution) to formulate and execute health programs that are both preventive (such as: vaccination, informational, fumigation, etc.) and healing (such as: surgery, radiation therapy, pharmacy, clinical, etc.) in nature. The Costa Rican Social Security Fund is also charged with the administration of the public pension system.
It offers comprehensive services: primary and specialist care, surgeries, hospital stays, medications, preventive programs, maternity, dental, emergency services. Emergency services are provided free of charge to all, including tourists. For more information, you can visit the Wikipedia page.
Enrollment in the Public Health Insurance (CCSS / Caja) System
In Costa Rica, enrollment in the public health insurance system (Caja Costarricense de Seguro Social – CCSS) is mandatory for all legal residents, regardless of whether they also have private insurance. For anyone moving to Guanacaste, this is a critical step.
- Who Needs to Enroll?
- All residents with a valid residency permit (temporary or permanent).
- Foreign retirees, digital nomads, investors, and other visa categories must be enrolled as part of their residency application process.
- Even self employed individuals, freelancers, and non working spouses are required to enroll and contribute.
- Subsidized Coverage for Certain Groups
- Costa Rica recognizes that not everyone can afford to pay full insurance premiums. As such, the government subsidizes or fully covers CCSS enrollment for specific vulnerable populations: low-income families and individuals, the elderly without pensions, people with disabilities, Indigenous communities, children and dependents of covered individuals, pregnant women, and unemployed individuals (in some cases, via social programs). These groups are often enrolled through social welfare programs and may receive partial or full premium subsidies depending on their income level and social status. This ensures universal access to healthcare, a cornerstone of Costa Rica’s public health philosophy.
- Contribution Amounts
- For most people: Contributions range from 7% to 11% of monthly income, depending on income level, employment status (salaried, self-employed, retiree, etc.), and family size. Employed residents typically have part of their payment deducted automatically from their salary. Retirees with foreign pensions (e.g., expats) often pay a flat monthly contribution based on declared income when applying for residency.
- Important Notes
- Proof of CCSS enrollment is required to obtain or renew legal residency.
- Enrollment is done at a local CCSS office (also known as an EBAIS), and residents need to submit: Passport or residency card, proof of income, and a utility bill or lease agreement (to verify address).
The Private Health Insurance Sector
Private insurance serves as a supplement to CCSS, offering faster access, more provider choice, English-speaking staff, and more modern facilities. Costa Rica offers a comprehensive healthcare system that combines public and private options, making it an attractive destination for those seeking quality and affordable healthcare services. The country’s healthcare industry is known for its accessibility, affordability, and high standards of care. Whether you are a resident or a visitor, you can rest assured knowing that you have access to excellent medical facilities and healthcare providers in Costa Rica.
Private Health Insurance in Costa Rica: Key Providers and Cost Estimates
While Costa Rica’s public healthcare system (CCSS/Caja) offers comprehensive and affordable coverage, many residents especially expats living in areas with high end homes, such as Flamingo Beach properties or Tamarindo Beach properties opt to use private health insurance for enhanced access, speed, and flexibility. Private coverage often includes shorter wait times, the ability to choose doctors and hospitals, and English speaking services in premium facilities. Costa Rica is a well known destination for medical tourism due to its affordable costs, bilingual medical staff, and strong healthcare reputation. Each year, over 40,000 Americans travel to Costa Rica for medical treatment. Private insurance is available through the government-owned INS and covers services such as dental, optometry, check ups, prescription drugs, hospitalization, and even full coverage for surgical and aesthetic procedures. Monthly premiums range from approximately $60 to $250 per person, depending on factors like age and gender. Many people choose private care for faster service and the freedom to select their doctors. About 30% of the population uses private healthcare at least once a year. The country has three internationally accredited private hospitals, with the most prominent being CIMA, Clínica Bíblica, Clínica Católica, and Hospital Clínica UNIBE, all located in or near San José. Private health insurance became legal in 2006, and international insurers entered the market after a 2009 free trade agreement with the United States
INS (Instituto Nacional de Seguros)
- Type: Government-owned insurance company operating in the private sector.
- Coverage: Covers up to 70% to 100% of medical expenses depending on the service and the chosen plan. Includes doctor visits, diagnostic tests, hospitalization, emergency services, dental and vision care, and in some plans, maternity and chronic illness management.
- Cost Estimate: Basic plans: $60 to $100 per month; Standard plans: $120 to $180 per month; Comprehensive plans (e.g., with dental, maternity, major surgeries): $200 to $250+ per month. Premiums depend on age, declared income, health status, and level of coverage.
- Enrollment: Available to residents and citizens. Some plans require upfront payment and are reimbursed after service. Others have agreements with private hospitals for direct billing.
Major Private Hospitals in Costa Rica
These hospitals offer high quality care and are commonly used by insured patients with INS, MAPFRE, or international insurance plans. Most of them offer English speaking staff, modern technology, and international accreditations.
- Hospital CIMA (Escazú): Located in a wealthy suburb of San José. Known for high quality service and being expat friendly. Popular for surgeries, diagnostics, maternity care, and internal medicine.
- Clínica Bíblica (San José): One of the most well established private hospitals in Costa Rica. Offers emergency, maternity, cancer, cardiology, and surgical care.
- Clínica Católica (Guadalupe): More affordable than CIMA and Clínica Bíblica. Specializes in maternity, surgery, and general medical services.
- Hospital UNIBE (San Pedro): Smaller private hospital offering outpatient care, diagnostics, and consultations. Ideal for basic check ups and diagnostics
Other Local and International Insurance Companies
Besides INS, several local and international insurers offer private health insurance in Costa Rica. These are popular among expats, frequent travelers, and higher income individuals who want broader access and international coverage.
- Local & Regional Insurers: MAPFRE, a Spanish-based multinational insurer, and ASSA Compañía de Seguros, a Panama based insurer.
- International Insurers: Cigna Global, Allianz Care, Blue Cross Blue Shield Global, and APRIL International.
Choosing the Right Private Insurance
- For Residents & Locals: INS is the most widely accepted and cost effective provider. MAPFRE and ASSA are great alternatives with more flexible service and fewer bureaucratic procedures.
- For Expats or Frequent Travelers: International providers like Cigna, Allianz, and APRIL offer broad protection with global coverage. These plans often include services in your home country, medical evacuation, and 24/7 multilingual support.
- Combining Coverage: Many residents and expats choose to maintain public CCSS coverage for routine care and emergencies and add private insurance for faster access to specialists and premium facilities. This hybrid strategy helps balance affordability and accessibility with convenience and speed of care.
Who Uses Private Healthcare in Costa Rica and Why?
Many expats and medical tourists prefer private healthcare in Costa Rica due to its higher convenience, shorter wait times, and modern facilities. Private care often provides more personalized service and access to English speaking professionals, which is especially valued by foreign residents, particularly those who have settled in areas like Tamarindo Beach properties or Flamingo Beach properties.
It is common for both locals and expats to combine the public system (CCSS) with private insurance. They use CCSS for basic or emergency care, while relying on private services for elective procedures, faster appointments, or access to specialists not readily available through the public system. This dual approach balances cost savings with high-quality care. A smooth transition to life in Costa Rica, whether you’re living in Guanacaste or commuting to the Liberia Airport, is key.
Choose a Healthier Life in Costa Rica’s Blue Zone
Living in Guanacaste isn’t just beautiful it’s good for your health. This region is part of Costa Rica’s famed Blue Zone, one of the few places in the world where people regularly live active, vibrant lives well into their 90s and beyond. With year round sunshine, fresh local food, outdoor living, and a strong sense of community, it’s easy to embrace a lifestyle that supports longevity and well being.
Read About the Blue Zone
We have an article about life in the Blue Zone in which you can discover how your move to Costa Rica can be a step toward a healthier, more fulfilling future.
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