Costa Rica offers some of the best health care in Latin America, and some say in the world. Because of the excellent healthcare, clean air and water, and laid-back lifestyle, Costa Ricans enjoy a life expectancy that is equal to that of more-developed nations. Many of the doctors and other health practitioners received their training in the U.S., and both private and public healthcare systems are continually being upgraded. We visited a private hospital, La Cima, in San Jose, and a newly built public hospital in Santiago de Puriscal during our 2014 Retirement Tour for the Non-rich with . Both hospitals were clean and orderly, and we did not see long lines on the day we visited. Doctors, hospitals, and prescriptions tend to cost considerably less than in the U.S., and that brings a lot of medical tourism to Costa Rica. During our two trips to Costa Rica, we heard numerous anecdotal stories from expats who have been very pleased with surgeries and dental procedures they’ve had performed on them in Costa Rica. Keep reading, and I’ll relate my own story.

Public Health Care

Costa Rica provides universal healthcare through the Caja Costarricense de Seguro Social which is typically referred to as “The Caja”. All citizens and residents are required to participate, and the monthly cost is based on your age and income. The monthly fee is 13% of the amount you declared for your residency, so the least that a new pensionado would pay is $130 per month per family. You may hear about expats who are paying much less than that; however, they came in under lower rates and were grandfathered in.

We’ve been told by many expats that the level of care they’ve received at both private and public health care systems is excellent. In fact, many doctors in Costa Rica provide services under both the private and public systems. However, the Caja’s low cost and high quality attract many to use their services, so there can be long waits for an appointment within the Caja.

Private Health Care

Many expats choose to supplement their Caja coverage with a private insurance policy or simply paying for private services when needed.

Private insurance plans are available through INS which is the government-owned insurance company which offers a full range of insurance services.

You can visit the official INS website at . The site is in Spanish, but hopefully, if you’ve made it this far in your research on retirement in Costa Rica, you’ve started brushing up on your Spanish. If not, many INS agents speak English, so you can contact one of them for assistance.

You can also obtain private health insurance though a number of companies that offer international coverage; however, you will likely pay more than you would through INS.


During our tour with George Lundquist, we learned that pharmacies play a different role than they do here in the U.S. Pharmacists are referred to as “doctor” or “doctora”, and they can actually diagnose and treat many common problems. For non-emergency situations, many go first to their neighborhood pharmacist. And many drugs, such as high cholesterol and migraine medications, do not require prescriptions. To test this information, George took us to the local pharmacy in Santiago de Puriscal. My body doesn’t assimilate vitamin B-12, so I require an intramuscular injection of cyanocobalamin every two weeks to prevent neuropathy, clouded thinking, and irritability. For about the first 15 years after receiving this diagnosis, I was able to purchase it in 30 ml vials in the U.S. without a prescription. In recent years, the FDA has started requiring a prescription for it, and over the past year, it has only been available in 1 ml (single dose) vials which are more expensive and more difficult to use. In addition, it has been in short supply and is frequently on back order when I order my prescription refill. We inquired at the pharmacy in Puriscal and learned that they sell a 5 ml vial for about $6, AND that includes the pharmacist doing the injections for you. I pay about $24.60 for 5 doses and syringes in the U.S., none of which is covered under my health insurance. I have to administer the injections myself, and I’ll have to make another appointment with the doctor soon to get my prescription refilled.