Healthcare — what Canadians actually use.

Costa Rica is one of the few Latin American countries with universal public healthcare. Every legal resident must enrol in CAJA (Caja Costarricense de Seguro Social) — and once you're in, you have full access: primary care, hospitals, prescription drugs, surgery, emergency response. Most Canadians who relocate keep their provincial health card active during Canadian visits and pair CAJA with private supplemental insurance for shorter waits and English-speaking specialists.

CAJA — the public system all residents enrol in

CAJA enrolment is mandatory within 90 days of receiving your DIMEX (residency ID). The cost is income-based, calculated on your declared monthly income (CPP/OAS for Pensionado, passive income for Rentista, etc.):

• Single: 7%–11% of declared monthly income
• Couple: same percentages but covers spouse + dependents
• Typical Canadian retired couple paying CAD $4,000/month combined CPP+OAS+pension: roughly $90–$180 USD/month

What CAJA covers

• Primary-care clinics (EBAIS) — free at point of care
• Specialist appointments (referral-based, longer waits)
• Hospital admission, including surgery
• Prescription drugs from CAJA's formulary (no co-pay)
• Dental basics
• Emergency response and ambulance

Where CAJA falls short for Canadian retirees

• Wait times for non-urgent specialists can be months
• Language — most CAJA clinics operate in Spanish; English availability varies by region (Tamarindo good, Pavones limited)
• Drug formulary — newer/specialty drugs may not be covered; Canadians on specific brand-name medications often pay out-of-pocket at private pharmacies
• Elective procedures — knee replacements, cataract surgery, etc. — long queues

This is why most Canadian retirees use a hybrid model.

Private hospitals — where Canadians actually go for serious care

Costa Rica has three internationally-accredited private hospital systems, all of which serve foreign residents and visitors regularly:

Hospital CIMA San José

JCI-accredited. Many physicians US/Canada-trained, English-fluent. Walk-in specialty appointments same-week. Out-of-pocket prices roughly 20–30% of US/Canadian equivalent. CIMA is the default choice for many Canadian retirees on Pacific-coast properties — it's a 4-hour drive from Mal País / Santa Teresa, easier from Tamarindo / Nosara.

Hospital Clínica Bíblica

San José-based. Comparable to CIMA, with strong cardiology and oncology departments. International-patient services in English.

Hospital La Católica

San José-based. Affordable private alternative; widely used by middle-class Costa Ricans.

For Pacific-coast Canadians, smaller regional facilities also exist — but for anything serious, the drive (or 30-min Sansa flight to SJO) to CIMA / Bíblica is standard.

Private supplemental insurance

Two routes Canadians take:

INS (Instituto Nacional de Seguros) — local Costa Rican carrier

Costa Rica's national insurer offers private supplemental plans. Premiums for a 65-year-old Canadian: roughly $1,800–$3,600 USD/year for comprehensive coverage. Network covers all major private hospitals. Easy enrolment, predictable claims process.

BlueCross International / Cigna Global / IMG — international carriers

Premiums higher ($3,500–$8,000/year for 65-year-olds depending on plan), but coverage portable globally. Useful for Canadians who travel beyond CR or want US-care backup.

What this looks like in real Canadian practice

Most of our Canadian retired clients use a three-layer stack: CAJA for routine and emergency, private INS supplemental for specialist appointments and elective procedures, and a Canadian provincial health card kept active for the Canadian visits. Annual all-in cost: $2,500–$5,000 USD per person. Compare with the $7,000–$12,000+ Canadian snowbird US travel insurance bills they used to pay for Florida winters.

Keeping your Canadian provincial coverage active

Each province has its own rules on out-of-province residency:

• Ontario (OHIP) — up to 212 days outside the province per year and you keep coverage
• British Columbia (MSP) — 6 months out-of-province permitted
• Alberta (AHCIP) — similar to BC
• Quebec (RAMQ) — 183 days out-of-province; longer absence triggers re-application

If you split time between Costa Rica and Canada (typical Canadian-buyer pattern), you can usually keep your provincial card active during Canadian visits and rely on CAJA + private during CR visits. Confirm with your provincial ministry before you establish CR residency — rules change.

Prescription drugs

Most prescriptions you'd get in Canada are available in Costa Rica, often without prescription (pharmacist consults instead). Generic versions are cheap; brand-name drugs comparable to US prices. CAJA covers everything on its formulary; specialty meds you may pay out of pocket.

If you're on a specific brand-name drug, bring 90 days' supply when you first relocate, and have your Canadian doctor email the prescription details to a CR pharmacist (Farmacia Fischel chain, Farmacia La Bomba) so they can match equivalents.

This page is informational only — confirm current CAJA premium rates and provincial coverage rules with the relevant authority before relocating.