Health Insurance in Costa Rica

Living in Costa Rica as an expat offers a unique blend of vibrant culture, stunning natural beauty, and a welcoming community. Known for its “Pura Vida” lifestyle, the country encourages a laid-back yet fulfilling way of life. Expats are drawn to Costa Rica’s diverse landscapes, ranging from lush rainforests to beautiful beaches, and the country’s stable political environment makes it an attractive destination for those seeking a peaceful life abroad. With a relatively low cost of living and access to excellent healthcare, Costa Rica is a popular choice for those looking to enjoy an adventurous but comfortable life in Central America.

Costa Rica offers both public and private healthcare options. Its universal healthcare system, known as Caja Costarricense de Seguro Social (CCSS), provides 100% coverage to citizens, permanent residents, and visitors for a monthly fee based on income. The CCSS is renowned for its quality, making it a solid choice for most residents. However, for those seeking more immediate care or additional services, private healthcare is readily available.

While Costa Rica’s healthcare system is generally of excellent quality, it’s important to note that hospitals and private doctors typically require upfront payment, even if you already have health insurance. Fortunately, the cost of medical procedures is often a fraction of what you’d pay in the UK or the US, so it is generally a more affordable option overall. Costa Rica is often regarded as having one of the best healthcare systems in Latin America, with modern facilities, advanced equipment, and highly trained professionals.

However, the public healthcare system can be overwhelmed at times, leading to long wait times for non-urgent treatments. In addition, it can be a challenge to find the right specialists, and patients are sometimes treated by general practitioners instead. As a result, many expats opt for international health insurance to avoid delays and to have more flexibility in choosing healthcare providers.

Healthcare in Costa Rica is free for Costa Rican citizens who can’t afford to pay for it themselves. Non-citizens and those who are working will be required to pay for their healthcare. How much they pay will be based on their income, whether from a salary or pension. For those opting for private healthcare, costs will vary depending on the provider and services chosen.

Hospitals are generally of good quality in Costa Rica and are well-equipped. There are around 30 public hospitals across the country, with 16 located in the Central Valley, where 50% of the population lives. Costa Rica has a relatively small number private hospitals in the country, with most located around San José.

Foreigners can get health insurance in Costa Rica once they have been approved for their temporary or permanent residence visa. To register, you’ll need to visit a local Caja office, bringing your passport, proof of residency, and a registration request form from your employer if you’re working in Costa Rica. You must sign up for the Caja and present your receipt when collecting your residence card.

It is mandatory for all expats living and working in Costa Rica to enrol in the Caja, as it is a requirement for obtaining a residence permit.

Many expats in Costa Rica choose international expat insurance to give them access to Costa Rica’s private healthcare facilities. This gives them more flexibility in their healthcare provision and also helps them to avoid long wait times and delays for treatments that often occur in the public system, as well as access to English-speaking healthcare professionals.

There are many options for visas if you want to live and work in Costa Rica – if you plan on staying in the country for longer than 90 days, you will need to apply for one of these temporary residence permits. The process can sometimes be complicated, and it can be beneficial to gain professional help to guide you through the applications.

When you move to Costa Rica to work, you’ll have to first apply for temporary residence and apply for a work permit once you are already in the country, at the Immigration Department. If you already have a job, the company can apply for your permit on your behalf. 

If you only have temporary residence, you will also have to prove why your role couldn’t be filled by a local Costa Rican citizen, i.e., because you have specialist skills, experience, or qualifications for the role. If you have permanent residence, you will be able to work with no restrictions.

You can also apply for a digital nomad visa, known as a rentista visa, which allows freelancers and self-employed people to live and work in Costa Rica for businesses based outside of the country. You will have to prove you earn at least $2,500 per month and have $60,000 deposited in a bank account. 

Once you have your work permit, you will also be able to bring dependents with you to live in Costa Rica, such as your spouse and children.

If you want to study in Costa Rica, you’ll need a student visa. You’ll first have to apply for a provisional student visa in your home country and can then apply for a proper study visa at the Immigration Department once you’re in Costa Rica. You’ll have to apply within 60 days of entering the country.

You’ll only be able to stay in Costa Rica for as long as your study programme lasts. If you wish to stay longer, you can apply for a temporary residence permit and work permit.

The pensionado visa is specifically for people who want to retire to Costa Rica. There is no minimum age to apply for this visa, but you will need to submit evidence that you are receiving a pension and will need to prove you will continue receiving this pension.

You will need to have a monthly income of at least $1,000. You can apply for the retirement visa as a married couple and only one person needs to have the monthly income.

Yes, you can live in Costa Rica permanently after you have lived there for a certain period. Usually, if you have had a temporary residence permit for two or three years, you can then apply for permanent residence.

You can also apply for permanent residence if you have a family member who is a citizen of Costa Rica.

Finding a job in Costa Rica as an expat can be difficult. The country has a high unemployment rate and so there is high competition over jobs. Locals are highly educated and favoured for positions and protected by law. However, with the right experience and qualifications, you can successfully find a role.

It is also possible to work on a self-employed basis or as an entrepreneur in Costa Rica, with specific working visas available for each of these.

Another challenge with working in Costa Rica is that salaries are generally low. The average salary is around £40,000 per year but cost of living is also low, so expats can typically enjoy a good quality of life.

People do not have to pay tax on income earned from foreign sources, so those who are working as a digital nomad in Costa Rica and retired people are exempt from income tax. However, they may still be liable to pay tax in the country where the revenue has been earned.

Expats may be liable to pay property taxes, sales tax, and import tax. Property taxes are very low, less than 0.5%, and can be paid annually or quarterly. Sales tax is the equivalent of VAT and is paid on items that are bought at the point of sale. If you are moving your belongings to Costa Rica, you will have to pay import tax, which can range from 1% to 15%, depending on the item.