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What are my Health Insurance Options ?

What are my Costa Rica Health Insurance options?

If you intend to live in Costa Rica and are looking for health insurance options you need to understand that Costa Rica has a two-tier medical care system. On the one hand is the Public health care option known as the “Caja”.  It is called the “Caja” because the services are administered by the Costa Rica Social Security System (Caja Costarricense de Seguro Social).

The Public Health Care Option

The CAJA provides 100% coverage for all medical procedures and prescription drugs, through the public hospital and clinic system, in various locations throughout Costa Rica. Under this coverage, you will be assigned a doctor on an available ‘first come, first served’ basis, and long waits may be experienced, for non-emergency medical attention.  Premiums are generally lower for this coverage.  The CAJA is the coverage that the majority of Costa Ricans use. Those of you that are considering applying for residency in Costa Rica will be required to pay into the CAJA as part of the immigration application process.

Private Medical Insurance

The second option is the private medical system. For many years the only private local option available was the insurance coverage purchased from the National Insurance Institute (I.N.S.) which is owned by the Costa Rican government and known as INS Medical.  Since the Insurance field was opened up in Costa Rica more Insurers are entering the marketplace and offering health insurance coverage.  Some examples are MAPRE offering a policy of Seguro para Gastos Medicos Colectivos.  MAPRE is an insurance company from Spain.   Also present in Costa Rica is Blue Cross Blue Shield of Costa Rica which offers several different health care plans which provide both coverage in Costa Rica and in the United States.  BMI Insurance (Best Meridian Insurance Company) out of Miami, Florida has established Costa Rica operations and is also offering medical insurance coverage

With all the private insurance options the insurance premiums are based on age, a medical examination, and a disclosure statement detailing your prior medical history must be completed. Insurance coverage may be denied for pre-existing medical conditions. Under private insurance coverage, medical treatment is dispensed through a number of private clinics located in the San José area, on an appointment basis, and deductibles will apply depending on the policy provisions.

Does US Medicare Apply in Costa Rica

Medicare does not cover any services in Costa Rica. Unfortunately the lack of this option creates a dilemma for those considering Costa Rica as a potential retirement destination. If they have any pre-existing conditions then most of the local private insurance companies will not cover them or the premiums will be very expensive to do so. This leaves some retirees with the option of relying on the Costa Rican public health care system and the having to travel to the U.S. to access any medical care using their Medicare coverage.

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Hi. This is Roger Petersen. Welcome to CostaRicaLaw.com, the Costa Rica Legal Information Site. Don't miss out on important legal changes or events occurring in Costa Rica. Sign up for the Subscriber Advantage Network for free.

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