Health Care in Costa Rica – Caja: Everything You Need to Know
Health care is an important aspect of our lives, which people often consider when moving to a new country. If you’re considering moving to Costa Rica or planning a long-term stay there, you may wonder about the country’s healthcare system. This article will answer frequently asked questions about health care in Costa Rica and Caja, including how to enroll in the system and what it covers.
Caja (CCSS)
The Caja Costarricense de Seguro Social (CCSS), commonly known as the CAJA, is Costa Rica’s socialized health care system. It provides a basic pension savings plan and health care to Costa Rica. The CAJA is similar to Social Security in the United States, and it is essential to know what it is before delving into the details of the healthcare system in Costa Rica.
Enrollment in the CAJA provides access to various medical services, including preventive care, emergency services, specialized care, and hospitalization. The system operates through a network of clinics and hospitals throughout the country.
Enrolling in the CAJA
The most common way to enroll in the CAJA is through one’s job. Your employer must provide CAJA insurance if you are legally working in the country. The employer would obtain your passport number or DIMEX number (if you’re a resident), provide that information to the CAJA, and ask for an ID number for the CAJA in return. Your employer then must pay the pension/health care payment in the first six days of each month.
If you are not employed, you can still enroll in the CCSS as an independent contractor or a volunteer. In this case, you must go to the CCSS offices directly to enroll. It’s worth noting that you can only enroll after your residency has been approved.
Pre-existing conditions
The CAJA does cover pre-existing conditions. This is one of the most significant benefits of the CAJA system in Costa Rica. Unlike many private insurance plans, you won’t be rejected because of any current health conditions you might have. As long as you are up-to-date on your payments, you will have access to doctors and medication for “free” (i.e., outside of the fee you are paying per month). No one is denied access to treatment because of pre-existing conditions.
This means that if you have a chronic condition such as diabetes, hypertension, or arthritis, you can receive medical care and treatment through the CAJA system in Costa Rica. It’s important to note that while the CAJA does cover pre-existing conditions, there may be some limitations on coverage or treatments available depending on the specifics of your condition. It’s always best to consult with your doctor or the CAJA directly to get more information on what treatments and medications are available to you.
EBAIS and Registering
EBAIS is the local health clinic where you can see a doctor or receive urgent care. To register, you will need your Orden Patronal (if you’re a worker), your ID (passport or DIMEX), a utility bill (electric, water, cable/internet, etc.), and a copy of your lease or a “declaración jurada,” which is a sworn statement made to a lawyer that confirms your place of residence. Enrollment in the EBAIS is usually completed within a few days of providing the necessary information.
How Do I Get an Appointment at my Local EBAIS/Clinic?
To make an appointment at your local EBAIS, you must visit the clinic early (around 6 am) and wait in line for your turn. However, some clinics offer online appointment booking through the CAJA app called EDUS.
What Private Insurance Options are Available in Costa Rica?
If you prefer to opt out of the CCSS and choose private insurance, several providers exist, including INS and Pan-American Insurance. Each company offers different packages and prices; most require a physical examination before providing coverage. It’s worth noting that pre-existing conditions are often excluded from coverage.
What are the Main Private Hospitals in the Country?
Costa Rica has several private hospitals, most in the Central Valley region. The leading hospitals are Hospital CIMA, Hospital Metropolitano, Hospital Clinica Biblica, and Hospital La Catolica.
What Other Health Care Options are Available?
Medical discount plans in Costa Rica, such as MEDISMART, offer access to private doctors, vets, dentists, and pharmacies at a reduced cost. MEDISMART is primarily linked to Hospital Metropolitano, but other private hospitals may have their discount plans.
What Recommendations do you have for Medical Coverage in Costa Rica?
Enrolling in the Caja is strongly recommended as it covers catastrophic cases, organ transplants, heart attacks, and chronic illnesses like diabetes. It also provides pension coverage for younger residents planning to live or work in Costa Rica. However, for non-emergency care, private insurance or a discount service like MEDISMART may offer faster access to care and more personalized service.
Conclusion
Health care in Costa Rica is considered some of the best in the world, and the Caja is a significant part of it. Understanding how to enroll in the Caja and its associated fees is essential for legal residents and those considering relocating to Costa Rica. Costa Rica is a great destination for expats with its excellent medical facilities, highly trained medical staff, and affordable health care system.
-Written by Glenn Tellier (Founder of CRIE and Grupo Gap).
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Frequently Asked Questions
Can I use my home country’s health insurance in Costa Rica?
It depends on the type of health insurance you have. Some international health insurance plans may cover medical expenses incurred in Costa Rica. However, checking with your insurance provider before traveling to Costa Rica to confirm what is covered and what is not is essential.
How do I find a doctor or specialist in Costa Rica?
There are several ways to find a doctor or specialist in Costa Rica. You can ask for recommendations from locals, friends, or colleagues or use online directories such as the Costa Rican Medical Association’s directory. You can also check with your health insurance provider to see if they have a list of approved doctors or clinics.
Are prescription medications readily available in Costa Rica?
Yes, prescription medications are readily available in Costa Rica. They can be purchased at pharmacies, which are found throughout the country. However, some medicines may require a prescription from a local doctor.
How much does a typical doctor’s visit cost in Costa Rica?
The cost of a doctor’s visit in Costa Rica varies depending on the doctor and the appointment type. A routine check-up with a general practitioner can cost between $50 to $100, while a specialist consultation may cost more. The cost may also vary depending on whether you have health insurance or not.
What is the quality of health care like in Costa Rica?
Costa Rica has a reputation for having high-quality health care. The country’s health care system is ranked higher than that of many other countries in Latin America. Many doctors and medical professionals in Costa Rica have received their education and training in the United States or Europe.
Can I purchase travel insurance for medical emergencies in Costa Rica?
Yes, you can purchase travel insurance covering Costa Rica’s medical emergencies. Many travel insurance providers offer plans that include medical coverage, including emergency medical evacuation.
What should I do in case of a medical emergency in Costa Rica?
In a medical emergency in Costa Rica, you should call 911 or go to the nearest hospital or clinic. If you have travel insurance that includes emergency medical coverage, contact your insurance provider as soon as possible to inform them of the situation.
What is the Caja in Costa Rica?
The Caja Costarricense de Seguro Social (CCSS), commonly known as “La Caja,” is Costa Rica’s public healthcare system. It provides healthcare services to Costa Rican citizens, permanent residents, and tourists who purchase temporary health insurance.
How do I get Caja in Costa Rica?
To enroll in the Caja, you must be a resident or a citizen of Costa Rica. You can also enroll as a temporary resident with a work permit. Once you have your residency or work permit, you can register at your nearest Caja office.
How much does private health insurance cost in Costa Rica?
The cost of private health insurance in Costa Rica varies depending on factors such as age, medical history, and the level of coverage you want. A basic plan can cost around $80 to $150 per month, while more comprehensive plans can cost upwards of $300 per month.
Can I live in Costa Rica for $2000 a month?
Yes, living in Costa Rica for $2000 a month is possible, but it largely depends on your lifestyle choices and location. Living in a city or tourist destination will generally be more expensive than living in a rural area. Additionally, your monthly expenses will depend on your housing, transportation, and food costs.
What is a good salary in Costa Rica?
The average salary in Costa Rica is around $800 per month. A good salary would be considered around $1500 to $2000 per month.
What is the minimum income to retire in Costa Rica?
There is no fixed minimum income to retire in Costa Rica. However, if you plan to apply for residency as a retiree, you must prove that you receive a monthly income of at least $1,000 USD from a pension or other guaranteed source.
How long will $100,000 last in Costa Rica?
The time that $100,000 will last in Costa Rica depends on your lifestyle and expenses. However, living comfortably on this amount for several years is possible if you are frugal and budget-conscious. Also, you can get your money working for you by investing with a company like Gap Investments.
Can you draw Social Security if you live in Costa Rica?
Yes, you can draw Social Security if you live in Costa Rica. As long as you are a US citizen and meet the eligibility requirements, you can receive your Social Security payments while living abroad.
What is the average cost of a house in Costa Rica?
The average cost of a house in Costa Rica varies depending on the location and size of the property. Generally, you can expect to pay anywhere from $100,000 to $500,000 and more for a house in Costa Rica. The cost may be higher in popular tourist areas or the capital city of San Jose.
What are the leading private hospitals in Costa Rica?
Most of the private hospitals in the country are located in the Central Valley region though there are a few in other locations. The leading private hospitals are Hospital CIMA, Hospital Metropolitano, Hospital Clinica Biblica, and Hospital La Catolica.
What other healthcare options are there in Costa Rica?
Some medical discount programs in Costa Rica are pretty good. MEDISMART is the name of one of them. Private doctors, veterinarians, dentists, and pharmacists participating in the MEDISMART system offer significant service discounts for a cheap monthly fee (about 8,000 colones). People frequently receive 20-30% discounts on services, medications, and other items.
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Article by Glenn Tellier (Founder of CRIE and Grupo Gap)