Last year, as reported by local news in San Jose Costa Rica, 100,000 persons traveled to Costa Rica for medical procedures. Majority of the patients were US citizens seeking relief from sky-rocketing costs of healthcare in America.
Medical tourism is booming in Costa Rica. Why? Because healthcare is world-class without the world-class price tags.
You might ask, well how good is it, really, comparing to US?
It turns out that Costa Rican healthcare system is highly rated (even higher than the U.S.), with universal health insurance and excellent public and private hospitals. Back in the early 2000s, the World Health Organization (WHO) rated Costa Rica’s general health higher than that of United States of America. Life expectancy is also longer in Costa Rica, despite the fact that healthcare spending is 87% less per capita. Comparing Unicef’s evaluations of USA and Costa Rica healthcare systems clearly shows that, in the last decade, the countries are very comparable. You can see the unicef reports for yourself: USA and Costa Rica.
And frankly the fact that Americans are flocking in the thousands to Costa Rica for medical procedures, speaks for itself.
Excellent quality aside, prices are what really draw Americans in search of healthcare options to Costa Rica every year. Persons traveling to Costa Rica receive the same quality (at least) of medical services for a fraction of the cost. Lower labor costs and absence of malpractice suits keep the prices of healthcare down in Costa Rica.
The reality is that Costa Rica’s reputation is growing for high quality, affordable, and accessible medical services. Some say that Costa Rica is a solution to the health care crisis in the USA. I’ve read that certain American insurance companies send individuals to other countries for major medical procedures (they often include airfare), in an effort to save money. Costa Rica has many advantages like being the closest foreign medical destination to the United States with cheap airfares and many United States trained doctors – who, by the way, often speak fluent English. There is no big culture shock for American citizens to come to Costa Rica.
Options for foreign residents (gringos) Health Insurance:
- National Public Health – CAJA – Costa Rica’s private system
- Private Insurance
a. INS – National Insurance Institute. The governmental insurance company.
b. International Health Insurance Policy
- US based Insurance – like Medicare
Let’s look at these one at a time.
1. None – no insurance
Recently an expat told me that I need to “get rid of my American mind set”, when it comes to insurance. He said that we are too dependent on the concept of health insurance. He said that instead, because healthcare is so cheap, many choose to use to forgo buying any insurance. Simply use the public health system for everything and pay as you need for the private health facilities for anything major. Considering that the costs are so low, he said that he chooses to be his “own insurance company”. Now, I must admit that is a very foreign concept to me but after some research, I realize that this may not be a totally bad way to go. If one is in good health, and has some savings, rather than paying insurance premiums it may be easier and even cheaper to just pay for healthcare as you need it. This also assumes that you are not planning on getting a permanent residency status which would require you to buy the public health plan. I’m not sure if I am sold on this concept but it is one option.
2. National Public Health:
In Costa Rica the public insurance is mandatory for everyone, citizens and foreign residents alike. The typical cost for two persons (retirees) is $50-60/mo. It covers just about everything and from what I understand the quality is quite good. There are also no preexisting conditions to worry about. The catch is that as any other public system – which is relied upon by a majority of the population – it’s often criticized for long wait times and delays in treatment. Nonetheless, many choose it as their main option or in addition to private options. I recently read a story of an American couple that uses it for basic and emergency care only and rely on other insurance for all major medical procedures. This obviously is a personal choice.
a) INS – National Insurance Institute, the governmental insurance company.
I know, I know, it seems odd that the government offers a “private” insurance option but it does.
Their private plans include dental work, optometry, well-visits and annual check-ups. Eighty percent (80%) of the costs are covered for prescription drugs, certain medical exams, sick visits and hospitalization. Surgeon and aesthetician costs are covered in full. The private medical insurance costs range from $60–$130/month per person. The premiums depend on gender, age, and other factors. Here is the catch: unlike the public CAJA, this insurance does not cover pre-existing conditions and there is a yearly maximum spend limit.
b) International Health Insurance Policy:
There are several International Health Insurance providers. They offer international insurance policies that cover your needs in Costa Rica but also in the rest of the world – this can be a great option if you like to travel and want to be covered no matter where you’re visiting. These medical insurance policies cover the medical expenses due to an accident or sickness. I’m told that the premiums for this type insurance are only a bit higher (but still very reasonable) than INS but cover more and the lifetime limits are much higher. Premium depends on the coverage and can vary according to the carrier. Here is the cool thing: they cover you when you are visiting US, as long as it’s for less than 30 days! – based on Bupa International Insurance.
4. US based Insurance –Medicare
Some expats choose to continue their US based insurance. For those that are eligible, Medicare is the obvious choice. I do not exactly understand why one would choose this option but some do – I suppose this stems from the mistrust of any health system outside of US and strong belief that our healthcare system, although not available to everyone, is better than most. This, I think, is a false belief. In 2010, The Commonwealth Fund compared healthcare in Australia, Canada, Germany, the Netherlands, New Zealand, and the United Kingdom – the U.S. health care system ranked last or next-to-last on five dimensions of a high performance health system. You can read the report here: http://www.commonwealthfund.org/Publications/Fund-Reports/2010/Jun/Mirror-Mirror-Update.aspx
Furthermore, this last option offers premiums that are generally higher than all the options above. There are also costs associated with flying back and forth to the US for treatment, in addition to paying premiums, deductibles, co-pays, and housing costs. I would venture to say that this option would be more expansive than no insurance at all in Costa Rica.
What is cool about all this is that expats can pick and combine any of the above. One can for example, combine the public healthcare with private insurance. I don’t know about you but that all sound good to me! I wish we had the same here in the US. OK, I wish we just had options…
You may also like our other posts on Costa Rica.