How Does Healthcare Work for Expats in Costa Rica?

Last reviewed October 27, 2026

Costa Rica has two layers: the public Caja (CCSS) and private care. Legal residents are generally required to enroll in the Caja as part of the residency process, and many expats also carry private insurance or pay privately for faster access to specialists and elective procedures.

The Caja (public system)

Registration with the Caja (CCSS) is part of the residency process, and proof of enrollment is typically needed before the residency card is issued. Voluntary members, such as retirees and people with independent income, pay a monthly contribution based on a percentage of declared income; the percentages change, so they are confirmed at enrollment. The Caja’s main drawback is wait times for non-urgent specialist visits, diagnostic tests and elective procedures.

Private care and insurance

Local insurers offer plans that cover private facilities in Costa Rica, and premiums depend on age and coverage. Pre-existing conditions and age limits can apply. International plans that also cover care abroad are the most expensive option. Some expats simply pay out of pocket for consultations and minor procedures.

Choosing where to live with healthcare in mind

Access to hospitals is one reason many buyers consider the Central Valley, where Atenas is located. See where to buy property in Costa Rica and Veritas Village Atenas.

Frequently asked questions

Do expats have to join the Caja in Costa Rica?

Legal residents are generally expected to enroll in the Caja as part of the residency process. Enrollment details should be confirmed with the CCSS or your attorney.

How much does the Caja cost?

Voluntary members pay a percentage of declared monthly income. The exact percentage changes over time and is set at enrollment.

Do I need private health insurance in Costa Rica?

It is not required, but many expats add private insurance or pay privately because the Caja can involve long waits for specialists and elective procedures.

Related guides

Thinking about living in a Veritas Village? Our team can answer your questions about communities, homes and the buying process.

Sources

This guide is general information compiled from the public sources above. Immigration, tax and property rules change often and vary with your situation. It is not legal or tax advice; consult a qualified attorney or accountant before you act.