Should I obtain expat health insurance in Costa Rica or are the costs of private healthcare low enough to pay out of pocket?

Many expats shared their experiences at private hospitals in Costa Rica on our Costa Rica forum. Based upon these discussions, the billing practices at private hospitals is similar to the billing practices at hospitals in the United States. One expat recalled, "My wife and I have Medicare Parts A & B, which we use for some medical services when visiting the USA and will have in case of major health issues later for which we might want to have done in the USA. We also have international health insurance which covers us 'worldwide, excluding the USA'. It excludes some pre-existing conditions. My wife had an emergency in CR and went to a private hospital by ambulance. Our insurance paid about $34,500 - we only had to pay our deductible. (The hospital originally billed about $70,000, but the insurance company negotiated that down.)"

According to the US State Department, "We strongly recommend supplemental insurance to cover medical evacuation in the event of unforeseen medical complications. An air ambulance flight can cost $25,000 to $50,000 USD and will often take place only after payment has been received in full."