Health insurance in Costa Rica

Costa Rica has two sides to its healthcare system. Public CCSS (Caja) for enrolled residents and life-threatening emergencies. Top private: CIMA (Escazu), Clinica Biblica (San Jose), Hospital Metropolitano - all JCI-aligned with bilingual staff

Nomads and expats typically use private clinics in Tamarindo, Nosara, Santa Teresa, Puerto Viejo, San Jose Escazu, Atenas. With an international long-term plan, you choose the clinic yourself and, where possible, the insurer pays the hospital directly so you do not have to cover a large bill on the spot.

Visa and residency rules in Costa Rica matter for two reasons: which permit lets you stay long enough, and whether private health cover is required as proof.

Required for Estancia (Digital Nomad) Visa under Law 10008 (launched 2022); required in practice for Pensionado, Rentista and Inversionista. Tourists not legally required but strongly recommended given Level 2 advisory and high private costs

These rules apply to: Non-resident foreigners staying beyond 180-day tourist entry or working remotely from Costa Rica; Estancia visa for remote workers earning 3,000 USD/month (4,000 USD with dependents) from foreign sources. Visa rules change often and depend on your passport, so always confirm with the official immigration service before you apply.

Yes. Your home-country public health insurance will not pay abroad for long, and the public system in Costa Rica is rarely a real option for foreigners. Without private cover you pay every bill yourself, from a GP visit to a flight home.

For a stay of three months or more, an international long-term plan is the only thing that really works. It is permanent, it covers ongoing and chronic treatment after the waiting period, and you can choose any clinic in the country.

The biggest real risks in Costa Rica are concrete and country-specific, not abstract.

Dengue (Chorotega and Central Pacific hotspots), rip currents and surf injuries, scooter/ATV crashes on unpaved Pacific coast roads (Santa Teresa, Nosara, Montezuma), road traffic, fer-de-lance snake bites in rural lowlands, petty and occasional violent crime in San Jose downtown

Risk level: Moderate (US Level 2 Increased Caution, April 2026; crime, rip currents, road safety). Good cover pays for both the treatment and the transfer to a specialist clinic.