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Can U.S. Citizens Living in Costa Rica enjoy Medicare Benefits

by Ivo Henfling for the Easy Times

U.S. citizens and Medicare benefits in Costa Rica

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.

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.

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I DO want to remind our readers that we appreciate any referrals you can send us. I know you all meet people on the plane, in the supermarket, at yoga, at the gym, at the beach or in a restaurant. Please remember the American European real estate Group’s agents when you talk about your home in Costa Rica when you meet someone who wants to purchase one, we appreciate it.




Ivo Henfling

Ivo Henfling started the American European Real Estate Network Costa Rica in 1996 and has grown it into the largest Costa Rica MLS with thousands of up to date property listings for sale and for rent. Ivo has written hundreds of articles about real estate and living in Costa Rica for The Tico Times and other online informational sites.

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