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Can U.S. Citizens Living in Costa Rica enjoy Medicare Benefits
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U.S. citizens and Medicare benefits in Costa Ricaby Ivo Henfling for the Easy Times

Deciding to move to Costa Rica requires a lot of due diligence and checking if your existing medical insurance covers you outside your home country is a very important question. Many expats move to Costa Rica because healthcare cost is significantly lower than it is in the US and Canada.  

One of the main obstacles restricting many future US expats who dream of an international retirement is the fact that Medicare coverage stops at the US border.  A pensioner’s eligibility to any other form of health insurance abroad can be strictly limited and prohibitively expensive.

In Costa Rica, to obtain legal residency, you need to get yourself registered at the Caja Costarricense del Seguro Social (C.C.S.S. or simply Caja) as well as many options to get yourself private insurance through INS as well as many private CCSS is the Costarican Social Healthcare systeminternational insurances that are accepted by The CIMA hospital and the Clinica Biblica, the larger private hospitals in Costa Rica.

La Caja

Officially, you have to pay 9% of your income to the Caja, which is a lot of money if you are healthy and you don’t need their services. But now, to be able to get legal residency, you also need to register at the CCSS, the Costa Rican Department of Social Security. For a long time, the ARCR gave you the option to get into the Caja through their system, but I think it is no longer available for newcomers.

After 18 years of not paying into the Caja system myself, to be able to renew my legal residency, I needed to get registered again, which I did through my company. To be able to do so, you need to register your S.A. (local corporation) with the CCSS and then register yourself as an employee of that company. You should be able to register yourself as a “voluntario” but I’m not sure you can get away with that since this option is meant for those who don’t have any income. Ask your residency attorney (make sure you use a specialized attorney located in Costa Rica to apply for your legal residency in Costa Rica) how to get your Caja registration.

The Caja has 29 hospitals throughout the national territory, including a national children hospital, a geriatric hospital and a psychiatric hospital.


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INS Medical

The Instituto Nacional de Seguros (I.N.S.), an insurance company owned by the Costarican government, has a real good medical insurance that covers 80% of any medical treatment, hospitalization and prescriptions called INS Medical. You can email our agent Isidro Gonzalez in English for more exact information and to get a cost picture. I have had INS Medical myself for many years and its much cheaper than some international health insurances I have had myself, like Danmark and AETNA for example.

You need to be a legal resident of Costa Rica to get INS Medical.

INS Medical is the Costarican private healthcare insuranceINS Medical coverage includes

a) Maternity, Transplant, Surgical implants, Congenital diseases of the newborn, Prematurity, epidemic and pandemic diseases, accidents during practice of recreational diving and soccer, cost of Air Ambulance, Sports, Medical treatment for mental or nervous disorders, Emergencies during travel abroad and overseas medical expenses, among others.

b) Travel Assistance Coverage.

c) Coverage checks, including ophthalmologic check-up checkup.

d) Death coverage, which protects Death, Burial and Liberation of the insurance payment direct death benefit.

e) Emergency dental coverage.

You can read more information about accepted international health insurances that are covered by the local private hospitals in my blog next week.

Feel free to leave your comments on this blog.

Comments (4)
Ivo Henfling says:
For INS Medical, tests are not necessary for applicants younger than 55(both sexes). Over 55 years, in addition to the normal application and requirements, you need to do the following physical tests: Practitioner Report to detail and explain the diseases that you have or have had in the past, physical examination, urinalysis, cholesterol, DHL, triglycerides, glucose and PSA (men), electrocardiogram and cardiovascular assessment. Except for the report of the doctor, the other tests are covered by the INS, and must be performed by authorized providers. The insurance can be given only to nationals or permanent residents with free condition, not for foreigners with temporary residency, even if they are in the process of getting their residency. Pre-existing medical conditions are not covered.
05/15/2013 03:46 PM
samramon says:
9% of income for CAJA? So if I am getting $1000/month (rounding off to make it simple) Soc Sec that means $90 a month. Is that for my wife AND me, or each of us would pay $90 (I would be collecting soc. sec, not my wife)? Also, can you give us a ball park figure on what the other insurance costs, the INS Medical?
05/16/2013 10:09 PM
Ivo Henfling says:
Thanks for your note Samramon. Yes, that would be $90/month for BOTH you and your wife. To be able to collect social security, you need at least 240 "cuotas" to be able to collect (20 years of steady payments). Unfortunately, I cannot give you a ballpark figure on the cost of INS medical. But my insurance agent, Isidro Gonzalez, will do so with pleasure: seguros1@racsa.co.cr
05/20/2013 08:44 AM
Ivo Henfling says:
Wayne W. says: one can pay Medicare every month upon eligibility, and travel back to the us of a, and with time, receive treatment, but the INS international policy is not too bad.
05/20/2013 08:46 AM

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