Expats Talk about Health Insurance and Healthcare in San Jose, Costa Rica
Last updated on Feb 05, 2023
Summary: San Jose, Costa Rica is home to several hospitals and clinics, including Hospital Mexico, Hospital San Juan de Dios, Hospital La Catolica, and Clinica Biblica. Emergency services in San Jose are generally reliable, and ambulances can be called by dialing 911. The quality of medical care in San Jose is generally comparable to that of the United States, though some specialized treatments may not be available.
How are healthcare services San Jose?
When we asked expats and global nomads about the quality of medical care in San Jose, they replied:
"If you're a resident you pretty much have to enroll in the Caja, the public health system, and if you aren't, you can't. So there's that. Whether or not you enroll in the Caja, if you have the funds, private insurance is nice. INS, the state insurance company, sells a pretty good policy for not too much money, and (ahem) it's darn near customary not to mention pre-existing conditions on the application. After a year or so INS doesn't care, and it does pay. Blue Cross and others have now entered the market, but I doubt they're as lax as INS. Of course, you can always pay out-of-pocket for private at prices about a third of US prices, but even a third adds up. Me, I'm only in the Caja now, since I let my INS policy lapse, but that's because I'm poor. People of some affluence usually do both--private for ease and comfort, public as a backup. Oh, in the Caja plan on speaking Spanish. Most Caja docs will know a little English and a few will be fluent, but the system operates in Spanish and you can't count on anyone speaking English. In the private system almost everybody speaks English," added another expat.
Are healthcare and health insurance expensive in San Jose?
"I was paying around $100 a month for my INS policy, but crossed into the next age bracket plus filed a few claims and my premium doubled. It was still a good deal, but too much for me. The Caja tax is around $100 a month for a pensionado, unfortunately much higher for rentistas. It's set by your income, and most expats just pay according to the income requirements of their residency type. Caja services, including generic prescription meds, are 100% covered, so you never pay more than your monthly tax. Private docs are realistically $80 a visit. You hear of lower prices, but if you go to a specialist (including an internist) plan on $80. As a rule of thumb, pretty much everything else is around 1/3 the price it is in the US," commented one expat who moved to San José.
What are emergency services like in San Jose?
When we asked about emergency services, members in San Jose wrote:
"I'm about 2 miles from my assigned public hospital, Calderon Guardia, and roughly the same distance from two private hospitals, Catholica and Clinica Biblica. For an emergency I would go (and have gone) to the public hospital. It has everything 24/7, and there's no payment expected for admission to the ER. The private hospitals don't necessarily have the right specialists on site and sometimes want cash (in the thousands of dollars) up front to be admitted, even in an emergency. I knew someone who died from a heart attack, probably because she went to a private hospital first and didn't have $20,000 cash on her. At the public hospital, the quality of care is ultimately good on what counts--the docs save lives and patch people up--but it's a real zoo. Patients, maybe you, line the halls since ward space is limited, and yes wards are as good as it gets. Don't expect semi-private rooms, much less TVs, telephones, or internet access. It's like a MASH hospital, just larger, but if you need the ER, it will take care of you. You'll just be glad to get out as soon as you can, and vow to go private if it's not a real emergency," wrote an expat living in San José.
Will I need to travel to see a specialist?
"If you go private (and either pay through insurance or out of pocket), specialists are easy. They're everywhere and fast, friendly appointments are normal. If you're in the public system, specialists are often where the system breaks down the most. Everybody is assigned to a local clinic, and these are fine, but most local clinics don't have specialists. To see a specialist you're sent elsewhere, and this can take multiple visits simply to make an appointment (you actually need appointments to make appointments) and then when you finally get an appointment, it can be up to a year later. I've also had the clerk lose my file and tell me I needed to start all over again, although in fairness I once saw a specialist on the same day I was sent. Anyway, seeing specialists is often the weakest link in the public health system chain, and many locals just pay private at this point. But sometimes seeing a specialist in the public system is easy. It's a crap shoot," said one expat living in San José.
Are common prescription medications available in San Jose?
"The public system dispenses generic medicines free, and getting them is easy. But on the advice of a private doc, I pay retail for a name brand pill too. It costs me about a third or less the cost in the US. No prescriptions are necessary for most meds, and even when they are, you can sometimes sweet talk your way into buying them in a drug store without a prescription. Probably the cheapest drug store is La Bomba, and it won't budge on selling meds it's not supposed to, but most meds that require a prescription in the US don't need one here. For meds that the drug stores really aren't supposed to sell without prescriptions, I go to a more full service drug store and pay a little more. Specifically, I keep a supply of antibiotics on hand that by law need a prescription but I buy without one. Also, just in the way the system works, I know a drug store that sells the morning after pill, even though it's really not suppose to in a Catholic country," said one expat living in San José.
"I'm about two miles from both a public and a private hospital, but for emergencies you definitely want to go to a public hospital. The private hospitals don't necessarily have the staff onsite and want to be paid upfront. The ER room at the public hospital is a zoo (no one likes it) but once you convince the intake person that you're really sick the care is as good as anywhere in the world, just without the creature comforts. Convincing the intake personnel that you're really sick though can be a challenge. They're surrounded by people with the sniffles who really shouldn't be there. It helps to arrive by ambulance or to be bleeding or at least to have a heart attack," said an expat in San Jose.
What have your experiences during the pandemic with the local healthcare system been like?
We asked members about local medical facilities in San Jose, they wrote...
"Although the authorities kept warning that the healthcare system might collapse because of the pandemic, they seemed oblivious to the fact that it had already collapsed for many things and many people. I went 10 months trying to get the telemedicine appointment that supposedly replaced my canceled in person appointment, and went as long without canceled lab tests or prescription medicines. True, the system was still attending to urgent medical problems, and in fairness it was dealing with a pandemic, but a lot of us were on our own," remarked another expat in San Jose.
What advice do you have for expats having a baby in San Jose?
We asked expat moms who gave birth in San Jose about their experiences and advice they have for other moms to be. They said:
"Be sure to plan ahead and research the available medical facilities in your area so that you are well-prepared when the time comes. Additionally, you may want to consult with an obstetrician or midwife to ensure you understand the care and services available to you. Additionally, you may want to consider enrolling your baby in early childhood education classes, such as infant massage or yoga, in order to give them an excellent start in life. Finally, don't forget to build a strong support network of other parents and health professionals who can provide further assistance and advice throughout your journey," said one expat in San Jose, Costa Rica.
Are healthcare services good in San Jose?
We asked people if they have access to good medical care in San Jose. They wrote:
"San Jose, the capital of Costa Rica, offers numerous state-funded healthcare services. The city has several large public hospitals, as well as smaller clinics and specialty centers. There are also multiple private healthcare facilities within the city. Healthcare staff in San Jose are known for their compassion and excellent patient care. The services available in the city are comprehensive, ranging from basic care to specialty services such as cancer treatment. San Jose also hosts a variety of specialists, including allergists, cardiologists, and neurosurgeons," explained one expat.
"My insurance provides coverage at Hospital Biblical, a private hospital with an excellent reputation. It is not close: two buses and a short walk. Or a 6,000 colon cab ride ($11.50). Minor things like colds, infections, etc I go to the pharmacy," said another person in San Jose.
About the Author
Joshua Wood, LPC joined Expat Exchange in 2000 and serves as one of its Co-Presidents. He is also one of the Founders of Digital Nomad Exchange. Prior to Expat Exchange, Joshua worked for NBC Cable (MSNBC and CNBC Primetime). Joshua has a BA from Syracuse and a Master's in Clinical and Counseling Psychology from Fairleigh Dickinson University. Mr. Wood is also a licensed counselor and psychotherapist.
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- How are healthcare services San Jose?
- What are medical services in San Jose like?