Healthcare Options in Costa Rica

The CAJA

The Costa Rican government also views medical care as a public obligation. More than 50 years ago, the Costa Rican government created a workers' health insurance program that today covers around 90% of the population. This is because one worker may cover several members of his family under  his one policy. This system is known as the Caja Costarricense de Seguro Social more commonly referred to as the CAJA. In this system, even if you are not working you can pay a voluntary quote to obtain medical health coverage which could run you and your family about $100 a month.

This is the way most Costa Ricans receive national coverage, through their jobs or by paying an independent quote. This costs around $37 a month per person which covers just about anything. The drawback to the CAJA is that since it is practically free the system is overcrowded. Therefore, there are long waiting lists for certain specialized surgeries. If you select the CAJA then you must use the public hospitals or the EBAIS smaller clinics scattered all over the country.

INS

The other way to obtain coverage is through the government’s monopoly insurance provider INS or Instituto Nacional de Seguros. INS rates vary depending on age, sex, and physical condition. This costs around $50 a month per person, which covers 70% of exams, visits, drugs and hospitalization and 100% of surgeries and anesthesia up to $17,000. After age 75 you cannot apply for coverage. With INS you may select your own doctors and use private hospitals & clinics.

Using both th CAJA and INS

A resident may pay to have both services from INS and the CAJA if they like. This seems to be a very popular method among middle to upper class Ticos and foreigners. This mixed approach offers a variety of benefits which can help you avoid delays on processing time of your tests and major surgeries. The CAJA is always good to have to fall back on as well. In any case, if there is a major emergency and you choose to go to a private hospital and then the hospital is not able to take care of you, you will be sent to a public hospital. You can also used this mixed approach to obtain a second opinion if you feel it is necessary. This is a great option for anyone who would like to pick and choose when and where they need medical treatment anytime.