What is Caja?

One of the requirements for getting your residency status and having your DIMEX card (ID card) in Costa Rica is to enroll in the national healthcare system (Caja) upon approval of your residency application.

Caja (CCSS) – Costa Rican Social Security Fund ( Caja Costarricense de Seguro Social).
You have to be a member of the Caja and pay a percentage based on the income level you declared when you applied for residency.

There are public and private healthcare systems in Costa Rica. Many foreigners and ticos use both. Private clinics are a better choice if you are in a rush for anything that isn’t too expensive. If you can stand the long wait periods in the public system for more serious concerns, then it’s better to obtain your medical care at Caja, which also has a high standard of medical care.


Caja System

The Caja system consists of 2 elements:

  1. Healthcare coverage – SEM (Seguro de Enfermedad y Maternidad);
  2. Pension contributions – IVM (Invalidez, Vejez y Muerte), similar to SS in the USA or CPP in Canada.

Before, only the SEM payment was imposed on retired and investment residents. As for the IVM, the regulation specified that individuals could opt out of contributing to it.


New changes

As of March 16th of 2022, Costa Rican Social security rules and regulations have changed, facing a significant rise in Caja rates expenses…

According to the reform, immigrants must now have both SEM and IVM insurance, meaning both Healthcare and Pension plans. Six months after the update was published, it took effect on March 16, 2022. Residents who apply as retirees or investors will be subject to the new CAJA rates as of this date. Rentistas are also included but not explicitly mentioned in this new regulation.

Costa Rican law prohibits the adoption of new rules retroactively. As a result, people who signed up with Caja BEFORE MARCH 16, 2022, do not need to be concerned about these recent changes; they will not be affected.


How it works

Pensionado – you must provide Caja with your Proof of Pension (the same as you submitted to Immigration with your residency application earlier). Based on your pension amount, they will calculate your monthly payment.
Rentista – Caja will use the $2,500 USD monthly income out of your bank account in Costa Rica.
Investor – officially not specified yet.



1) Pensionado with $1,500 USD per month income:
(1,500 x 6.24%) + (1,500 x 7.20%) = $201.6 USD monthly Caja payment.
 Before: you had to pay 6.25% (for 1 plan, SEM)
Now: you will have to pay 13.44% ( for 2 plans, SEM + IVM)

2) Rentista with $2,500 USD per month income:
(2,500 x 8.2%) + (2,500 x 7.65%) = $396.25 USD monthly Caja payment.
Before: you had to pay 8.02% (for 1 plan, SEM)
Now, you must pay 15.67% (for 2 plans, SEM + IVM).

As you see, the Caja payments have almost doubled…



It’s uncertain if this ill-conceived system modification will continue to be the case, but only the outcome of future appeals will tell. The new administration, sworn in after the runoff election, may also assist in reversing or adjusting these rates.
It’s necessary to make a lot of noise about this issue in public forums, embassies, etc., to pressure the politicians and bureaucrats who can change it.

When compared to other countries, the Costa Rican healthcare system, despite its shortcomings and challenges, nonetheless provides greater value. Medical tourism is growing in its popularity immensely. One of the primary advantages of living in Costa Rica is the year-round availability of its unique healthy environment. Let us focus on what is still of really great value.

From our side, CRIE is working with a network of independent attorneys on preparing the appeals, which we hope will contribute to changing this regulation for a more fair solution.


-Written by Glenn Tellier (Founder of CRIE and Grupo Gap).

[email protected]

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  • Manny
    Posted April 15, 2022 10:25 am 0Likes

    Great Information Thank you .

  • Gloria
    Posted April 27, 2022 6:39 am 0Likes

    Well I’m not fully retired yet just partially at this time. So now this increase for Health Care is really extremely harsh.. How is they say retirement financial amount is $1,000 but they want more than 200.00 of that per month for health insurance. USA already does this anyway. And why do you need to pay for two different kinds now??It seems to me this is another government policy to make them more money and to push out retirees.. This situation is blantley Harsh no consideration for the people who want a Pensionado

    • admin
      Posted May 2, 2022 1:51 pm 0Likes

      Hi Gloria, we need to see if the new government is going to help things.

  • William Miller (Bill)
    Posted May 19, 2022 4:26 am 0Likes

    Very confusing situation. For instance, one expat took it upon herself during a recent visit to her Caja office to inquire about the new IVM contribution requirement. According to them it does not affect 65 and up,
    I have also read that certain ongoing expenses may affect your contribution, but that is rarely mentioned in the “Here’s your cost of living in CR” articles.
    Note for Gloria…
    The example given was for a $1,500 income. You would still be in that 13.4% bracket, but at $1,000 (minimum Pensionado income) the amount would be roughly $134, far less than my costs under US Medicare!
    Personally hoping for a clarification that exempts 65 and up from the pension portion of el Caja.

  • Ron
    Posted May 30, 2022 7:57 pm 0Likes

    What is required for permanent residents over 65 tp pay?

    • admin
      Posted August 22, 2022 4:49 pm 0Likes

      Please contact [email protected] for the details

    • admin
      Posted March 1, 2023 7:43 am 0Likes


      • Proof of $1000 USD per month income from a permanent pension source or retirement fund;
      • Must be in Costa Rica at least 1 day per year;
      • Cannot work as an employee.

      • Temporary Residency – valid for 2 years, renewable;
      • Can apply for permanent residency without conditions after 3 years;
      • Able to claim spouse and dependents 24 years of age and under;
      • You can own a company and receive dividends.

    • admin
      Posted March 1, 2023 7:51 am 0Likes

      Morning Ron, you can find all the information here. https://crie.cr/permanent-residency-in-costa-rica/

  • Stephen Reedberry
    Posted June 13, 2022 11:50 am 0Likes

    frankly this may very well price me out residency.
    i’m going to be receiving US social security in a few months, three years before i’m 65.
    i don’t even see there is any benefit to the additional charges.
    as retired military, i get my healthcare almost free in the US so it’s all just a gouge to me.

  • Don Phillips
    Posted July 5, 2022 1:07 pm 0Likes

    This may be a silly question, Is this cost per each individual? I’m married and the one with the pension. Trying to make we are not priced out. Thanks!

    • admin
      Posted July 8, 2022 11:04 am 0Likes

      Hello, Don! Please contact [email protected] for the details

    • admin
      Posted March 1, 2023 7:48 am 0Likes

      Hello Don Phillips; you can see all the prices here. https://crie.cr/residency-for-retirees-in-costa-rica/

      What do you need to get your Residency for Retirees in Costa Rica?
      • Proof of $1000 USD per month income from a permanent pension source or retirement fund;
      • Must be in Costa Rica at least 1 day per year;
      • Cannot work as an employee.

      • Temporary Residency – valid for 2 years, renewable;
      • Can apply for permanent residency without conditions after 3 years;
      • Able to claim spouse and dependents 24 years of age and under;
      • You can own a company and receive dividends.

  • Jo
    Posted August 1, 2022 10:04 am 0Likes

    Question: Caja for Pensionados – is it as follows:

    1) Income – less expenses. (*do you need receipts if this is the case? I don’t get receipts as I
    Shop at the Farmers Market for most of my food, and local grocery markets (have those receipts), and rent a room and have never asked for a receipt), transportation is public transit, unless I get a ticket from the metro station, I don’t get receipts.
    2) If over 65 is the Caja under the old rules of 6.5% and not the new Vat of 13.5%
    3) Any info on Law 9996 – I know it’s passed, pending implementation.

    Thanks for any info.

    • admin
      Posted August 22, 2022 5:40 pm 0Likes

      1)The expenses are not important. Your income is the only thing that matters. You only need to prove that you receive not less than $1000 USD per month.
      2) Caja rules are the same for everybody who signed up after March 16, 2022.
      3) No, this law hasn’t passed yet.

  • Izzy
    Posted August 4, 2022 12:40 pm 1Likes

    Omg I’m a new DIMEX resident and this is extremely difficult for me to pay si I’m in desparate need to know if I have to purchase the Cajon medical ins. or can I switch to Bluecross Blueshield which gave me a lessor estimate whuch I could afford. But not sure if its a problem with immigration Thx any info greatly appreciative.

    • admin
      Posted August 22, 2022 4:54 pm 0Likes

      It’s mandatory to be singed up with Caja if you are a new DIMEX resident.

  • Lise
    Posted December 8, 2022 4:05 pm 0Likes

    Caja .wife pension under 1000. So immigration has her as depediente however caja wants her to get her own account and pay separately. Or should we have one pymt based on his pension or total of pensions. They would not register her as a family dependent because she has a pension

    • admin
      Posted December 12, 2022 11:24 am 0Likes

      Hello, Lise! Only the main applicant pays Caja; dependents do not pay Caja (it doesn’t matter if the dependent has a pension or not, he/she is a dependent of the main applicant, which is also stated clearly and approved by Immigration). The main applicant should register with Caja, and the rest of the family will register at EBAIS as dependents.

  • Terrell
    Posted December 12, 2022 4:58 pm 0Likes

    Is there a maximum monthly amount that Caja is limited to and cannot exceed?

    • admin
      Posted December 17, 2022 12:04 pm 0Likes

      No, there is no maximum amount that Caja is limited to.

  • Lise Packer
    Posted February 22, 2023 5:27 pm 0Likes

    Are u aware if resident go out of the country for a few months and prove to caja their exit ticket and return date they wont be charged for caja for the months out of the country??
    Thank you

    • admin
      Posted March 1, 2023 8:00 am 0Likes

      Yes, that is true. You must let Caja know if you plan to leave for a few months or even years.

  • CJ
    Posted February 26, 2023 8:19 am 0Likes

    W0w – so is there an update to this in 2023? Did the law pass and are these the rates? Costa Rica is no longer a viable option for me if this is true. Europe is cheaper even with the exchange rate.

    • admin
      Posted March 1, 2023 7:56 am 0Likes

      The government is moving forward but has yet to tell us any new news that we don’t already know about. I’m hoping we will know more soon.

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