Health Insurance in Costa Rica
for Expats (2026)

Health insurance in Costa Rica for expats is a topic that requires more than the standard "get travel insurance" answer — because the options available, and the right combination for your situation, depend on your visa status, your length of stay, your health history, and what you are willing to pay for convenience versus waiting. This guide covers every option with honest assessments of what each actually provides and what it costs. 💊

CAJA — The Public System Foundation

The Caja Costarricense de Seguro Social (CAJA) is Costa Rica's public healthcare system — one of the most comprehensive in Latin America. For enrolled members, CAJA provides: GP care through local EBAIS clinics, specialist referrals and consultations, hospital treatment, surgery, emergency care, maternity, mental health services, most prescription medications, basic dental, and laboratory services. All at minimal or no additional cost at the point of care. The monthly contribution covers all of this. 🏛️

The limitations of CAJA that most expats encounter: wait times for non-urgent specialist appointments can extend to weeks or months. The facilities at lower tiers of the system are less comfortable than private options. CAJA dental is basic. Some specialist treatments are subject to waiting lists. For expats who need fast specialist access or specific treatments, CAJA alone is often supplemented with private coverage for those specific needs.

Who Can Enroll in CAJA

Legal residents of Costa Rica are required to enroll in CAJA as a condition of their residency. This includes: Digital Nomad Visa holders (mandatory), pensionados, rentistas, inversionistas, and residency-by-family-relationship holders. Tourist-visa holders can technically enroll as voluntary contributors, though this is less commonly done in practice. 📋

The enrollment process: visit the local CAJA administrative office (not the EBAIS clinic) with your DIMEX residence card, passport, and recent pay stubs or proof of income. The contribution is assessed at approximately 7–8% of your declared monthly income, with a minimum floor of around $75–80/month. A family enrollment covers dependants. The DIMEX card is required — you cannot enroll on a tourist stamp.

Private Insurance Plans

Private health insurance for expats in Costa Rica comes from several sources. INS (Instituto Nacional de Seguros) is the state insurer and offers private plans that work throughout Costa Rica's private sector. International expat health insurance from Cigna Global, Aetna International, GeoBlue, and Bupa Global all have coverage options that include Costa Rica and most cover San José's top private hospitals. 🌍

What private insurance adds that CAJA does not provide: dental coverage (often the most compelling addition given Costa Rica's excellent low-cost dental scene), faster specialist access, repatriation coverage for serious medical emergencies, coverage at private hospitals that provide English-language care and more comfortable facilities, and medications or treatments not on the CAJA formulary. Monthly cost for private plans: $80–$200 for a healthy person under 50, $150–$350+ for those over 50 or with pre-existing conditions.

Travel Insurance — For Tourist-Visa Holders

Tourist-visa holders without CAJA access need comprehensive travel or expat insurance. Standard short-trip travel insurance typically has coverage limits too low for extended stays. For longer stays, look for: expat health insurance (longer-term, renewable coverage) or travel insurance specifically designed for extended stays (World Nomads, SafetyWing, and similar). Key things to verify in any policy: maximum benefit per incident, emergency evacuation coverage, coverage in Costa Rica specifically, and what constitutes a "pre-existing condition" exclusion. 📋

The Right Combination

For legal residents: CAJA as the primary coverage foundation, supplemented by private insurance for dental, faster specialist access, and repatriation. This combination typically costs $150–$300/month all-in and covers most scenarios comprehensively. For tourist-visa holders: comprehensive expat or extended-stay travel insurance as the primary coverage, with out-of-pocket budgeting for minor private clinic visits. Never leave Costa Rica without any insurance coverage regardless of your health history — a serious accident or illness is unpredictable and can be expensive even at Costa Rican private rates. 💡

What It Costs

For the full cost picture including clinic prices, prescription costs, and what healthcare actually costs day-to-day: 💰 healthcare costs for expats in Puerto Viejo. See the full 🏥 healthcare and wellness hub.