Maternity Coverage under CAJA in Costa Rica

In a thread on the Costa Rica forum about Maternity Coverage & Baby Preparation, a newcomer asked, "We are planning to move to CR soon, and expect to have our second child there. Can anyone share details of what maternity coverage looks like under CAJA, and what items are cheaper/ make sense to bring from the US vs buying in CR? We have lots of hand-me downs from our first child, but don't want to take more than we need when we move. Some of the things we're wondering about: electric breast pump, crib, carseats, pack & play and cloth diapers. Any experiential advice on having a baby in CR would be appreciated!"

One member replied, "You and your family would not be covered by CAJA (public health care) until you have gained residency, which you would apply for (A) after the baby is born, (B) unless you applied under Temporary status, but this could take a year or more. Most expats use private facilities for 'maternity care or the actual delivery'. In our many years here, I have only met one expat family whose baby was born in a CAJA facility. Some of the larger private hospitals in San Jose, offers a maternity package which both Expats and many 'Ticas' use. CAJA facilities varies greatly, throughout the country. Obviously many babies are born in the CAJA facilities, but no 'partner' is permitted at the delivery and visiting hours are very strict."

Another expat clarified an important point related to CAJA and maternity coverage, "Re: CAJA coverage and birth. In Costa Rica children have a constitutional right to health care. This is irrespective of whether a parent is able to pay CAJA or not. All children have this right. A fetus has a right to health care, and by extension any pregnant woman automatically has a right to healthcare through birth. So you would not need to be actually insured by the CAJA to be seen through the pregnancy and birth. This applies even to extranjeros (people from other countries) as constitutional protections are extended not only to Costa Ricans, but also to everyone. So while it is technically correct taht you would not be eligible for CAJA coverage your baby, pregnancy and birth would be covered. However, it is also useful to note that Costa Rica has exceptionally high c-section rates (one hospital as high as 80%!!), and pitocin drip is standardly given upon arrival regardless of the level of dialation. Vacines are mandatory, and if you wish to delay vaccination for a newborn you may need to birth with a private doctor in order to have that option. Also when a child is a Costa Rican the child will require special permission and goverment permission to leave Costa Rica even if that child also has USA citizenship, (and even if both parents are present at the airport). While for some people this is a quick process for others it has been delayed. Costa Rica would not be my first choice for countries in Latin America to birth in."

Private Health Insurance for Expats in Costa Rica

Many expats choose to buy a specialized expat health insurance plan for Costa Rica. Typically, these plans provide coverage for private hospitals, like Hospital San Rafael Arcangel in Guanacaste, Clinica Biblica in San Jose and Hospital CIMA in Escazu. For more information about private vs. public healthcare in Costa Rica, read our article, 8 Important Tips about Healthcare for Expats in Costa Rica.

Expats living in Costa Rica interested in expat health insurance should take a minute to get a quote from our trusted expat health insurance partner, CIGNA.

Giving Birth in Costa Rica

"I recently gave birth to a beautiful baby boy here is San Jose, Costa Rica. I couldn't have had a better experience. I have a 3 year old daughter who was born in the states and with her I had to have a C-section. I really wanted to try and have a natural birth with my son, and most doctors will not even discuss that option with you after you have had a C-section. My doctor here at least let me give it a try, it did not happen but he was willing. I had my son at Clinical Biblica in downtown San Jose. After a C-section I left the hospital the very next day and my healing only took 2 weeks and I was back in the gym. It was amazing!! With my daughter it was a horrible recovery and it took weeks. The care I received from everyone was the best. I do not speak Spanish yet, but they were patient with me, and everything went better than I could have hoped for. I decided on Clinical Biblica from word of mouth, and after having my first visit there was very comfortable. My doctor was Dr. Salazar Mora," wrote one expat.

Some Words of Caution from One Expat Mom

"I had my son born in Costa Rica and it was a horrible experience. The doctor wouldn't let my midwife come into the delivery room. They took my son away after birth and gave him shots I did not approve, which made him very sick. The doctor cut me which was not necessary. They wanted to give me a c-section and it was hell to fight with the staff while I was in labor. His birth father and I had a falling out and he locked us in the country and would not sign the papers for us to leave, even though my son needed urgent medical attention. He used this as leverage to steal my marital assets and home once we left. Once you are a resident, the laws work against you if you ever get into trouble. Don't go to the consulate to help if you do, because they will just tell you that they too are a guest here and they won't get involved," recounted one mom.

Dual-Citizenship for Babies Born in Costa Rica with an American Parent

To register a child born in Costa Rica (with one+ American parents) as a US Citizen, you'll need to gather documents (see "Required Supporting Documents" list), fill out 3 forms (see " Required Forms" and instructions (IMPORTANT: do NOT sign them as that is done at the consular office in front of a representative) and schedule an appointment once you have the forms and documents ready. For detailed information from the US Embassy go to: US Citizens Services: Registering a Child Born in Costa Rica as a US Citizen.

According to the US Embassy in San Jose, "On the day of your interview, your packet will be reviewed at intake to ensure that all required documents have been submitted. If any required documents are missing, you may have to return to the Embassy with the missing documents. Please review the information below carefully to avoid multiple trips to the Embassy. The American Citizen parent must appear in person to sign the CRBA application. If both parents live in Costa Rica, they must both attend the initial interview, and, regardless of citizenship, both must sign the passport application in person (If only one parent is present in Costa Rica, the "Statement of Consent from Absent Parent," form DS-3053 (PDF 52 KB), is required for the passport). Both parents and child must be present at the interview. After the forms have been accepted and the fees paid, a Consular Officer will interview you. Once approved, the Consular Report of Birth Abroad will generally be ready for pick-up in 1?2 weeks." The fees total $215.

Having a Baby in Costa Rica Enables Parents to Apply for Permanent Residency

One expat explained, "Having your baby in CR will permit you to apply for permanent residency, AFTER you have received the birth certificate. Your application, could take approx one year at a cost of approx $2000. Your baby will have dual citizenship. The babies father name has be on the certificate and he has to sign paperwork for the baby to leave the country with you, which means the child may only depart Costa Rica upon presentation of an exit permit issued by the Costa Rican immigration office ("Migraci?n")."

Baby Stores in Costa Rica

In a topic entitled, Mother to be contemplating Costa Rica, a woman asked, "I'm currently a single mother to be, due in September. My mother has a condo in Guanacaste and spends half of her time there. I am thinking about having the baby there. Has anyone had the experience of giving birth in CR? Also wondering about the availability and cost of baby items such as cribs, etc. Any baby stores in San Jose?"

One member replied, "Ticos love children and babies. There are lots and lots of stores. You can spend as much or as little as you like. There are used items for sale from time to time. There are also ropas which are stores selling used goods, especially clothing. I would be very careful in selecting a doctor. I have been told, by nurses, that Latin America, in general, has a very high C-section rate and it is done for the convenience of the doctor."

Baby Formula in Costa Rica

In another topic on the Costa Rica forum about Baby formula?, one member asked, "I'm moving to Costa Rica in January with a baby who is bottle fed formula. He's on good start right now. I'm wondering what brands of formula are available there. Thanks in advance!"

A member in Costa Rica replied, "Here is a link for you, This is one of the stores chains here in CR, kind of high end. On the left hand side menu, go to CUIDADO PERSONAL E INFANTIL and then go to Alimento Formulas. There you will find a variety of baby formula price tags are listed too, divide the price by 530 and that will give you a rough idea of the price in $. I am sure you will be able to find some other or same brands at a cheaper price elsewhere."

Another expat added, "As mentioned by the previous poster, this is one of the best stores to purchase/find imported food, albeit one of the most expensive. Unfortunately, they are not all over the country. I asked around yesterday, but couldn't find any info on 'Good Start' formula. Similac seems to the most popular, at least in our area."

"Remember, Wednesday is 'dia del campo' at Auto Mercado, discounts up to 50% off through out the store. The one pound bag of Lay's potato chips is and probably always will be $10, sorry Lay's lovers. Pura Vida," said another expat.

Another expat in Costa Rica cautioned, "Seriously, I wouldn't recommend that you rely on being able to get the formula here, so I would suggest you bring it with you. Most Costa Rican mothers breast feed, so formula selection is very limited."

More Information

One member even posted a number of helpful links related to the cost of baby items, maternity coverage, residency, having a baby in Costa Rica and more:

Costa Rica Immigration and Residency Summary

Costs for obtaining residency in Costa Rica

Giving Birth (Again) at Hospital CIMA in Costa Rica

Maternity Plans at Hospital San Rafael Arcangel

Types of Residence