Can I receive treatment at a public hospital in Costa Rica if I am not yet enrolled in CAJA?

Summary: While you may receive treatment at public hospitals in Costa Rica before you enroll in CAJA, you will be required to pay before you are released.

For the time period during which you are not yet eligible for CAJA, you may wonder if you can receive treatment at a CAJA hospital. While you may be able to receive treatment, you will not be released until you pay the bill.

According to the US State Department, "Make sure your health insurance plan provides coverage overseas. Most care providers overseas only accept cash payments. See our webpage for more information on insurance providers for overseas coverage. Many health care providers and hospitals expect cash payment upon delivery of health service."

One expat said, "Having received treatment in both Clinic Biblica and Hospital Católica, believe me when you are ready to be discharged you are 'escorted' to the cashiers window' where you will pay any additional expenses that have been added to your bill, from their original estimate, which you would have to pay prior to treatment. You will be 'escorted' by a senior nurse at a CAJA hospital, as this is how it works even though you had to produce your cedula when being admitted to make sure your payments are 'up to date' especially if you have spent multiple days there. It would be 'too easy' for someone to 'skip the country' and not pay an outstanding account, once you have left the premises. Maybe you senior friend should consider it may be better to return to the US until her residency application has been completed. Just the other day, it was required that I update some changes with a new CCSS account and with this 'change' the date was different and the CAJA clinic would not permit me to follow through with my appointment...until I could arrange to go to their local office to sign the paperwork, which I couldn't do until next week, due to an appointment in another town the following morning. All the staff know me well, but there was no way they would let me hand in my x-ray and blood results to the doctor. They have their rues and they stick to them..."

Even after you become eligible for CAJA, many expats use a combination of CAJA and private medical care covered by private expat health insurance. This gives them the flexibility of seeing private doctors for more urgent or specialized treatment and using CAJA for more routine care.

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About the Author

Betsy Burlingame is the Founder and President of Expat Exchange and is one of the Founders of Digital Nomad Exchange. She launched Expat Exchange in 1997 as her Master's thesis project at NYU. Prior to Expat Exchange, Betsy worked at AT&T in International and Mass Market Marketing. She graduated from Ohio Wesleyan University with a BA in International Business and German.